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

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



Case Details

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VAERS ID: 1125905 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-03-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril Levothyroxine Vitamin D3
Current Illness: None
Preexisting Conditions: Hypertension Hypothyroid Vitamin D deficiency
Allergies: No known drug or food allergies
Diagnostic Lab Data: 3/14/21-unknown results
CDC Split Type:

Write-up: Pruritic rash on extremities began 3/11/21 and on 3/14/21 developed lip and facial swelling on right side of face requiring trip to emergency room at hospital


VAERS ID: 1125918 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood potassium decreased, Chills, Electrocardiogram abnormal, Headache, Hyperhidrosis, Hypokalaemia, Pain, Palpitations, Pyrexia, Sinus tachycardia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, Ortho Tri Cyclen, Probiotics, Magnesium, CLaritin, Vit D, FIsh Oil
Current Illness: No
Preexisting Conditions: Migraines, Fibromyalgia, NCS(neuro cardio syncope)
Allergies: Dicyclomine?
Diagnostic Lab Data: Blood work(low potassium), EKG(normal heart rhythm sinus tachycardia)
CDC Split Type: vsafe

Write-up: I exp headache, fever, body aches, chills, sweating and racing heart rate(tachycardia). I went to ER for heart rate shot up to 155 beats per min while sitting in a chair was prescribed Migraine and Benadryl. I do exp heart rate regulation which is usually under control unless I''m hot.


VAERS ID: 1125971 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Nervousness, Pharyngeal hypoaesthesia, Sensation of foreign body, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Client reported she was nervous and had a "thick lump" in her throat. she reported she has a peanut allergy and now carries an Epi Pen. Blood pressure 119/80 Pulse 90 and 02 Saturation 100%. Client continued to state she felt a lump in her throat and was offered benadryl nasally. Was able to tolerate left nostril dose of Benadryl intranasal 50mg so only got 25mg. Client reacted with yelling and cursing stating this made it worse and she felt her throat was now "burning" She was taken to an EMS vehicle to lie down and was monitored and treated by Dr and EMS. an IV was inserted by EMS and further medications given. Client continued to complain of the "lump in her throat" and that her throat was numb. Epi pen 0.3ml given at 12.40 pm by EMS along with Solumedrol 125mg and pepcid 20mg IV. Client needed to bee monitored following epi pen and was feeling better before transported by EMS to hospital.


VAERS ID: 1126200 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-05
Onset:2021-03-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abscess drainage, Rash, Skin culture, Skin discomfort, Skin swelling, Staphylococcal infection
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Easily get pneumonia
Allergies: None
Diagnostic Lab Data: Culture came back positive for MSRA infection
CDC Split Type:

Write-up: I developed a rash during the week after my vaccine. One week later the rash became severe and very uncomfortable and swollen. I went to the doctor where they drained the sores and took a culture. The results came back I have a staph infection and MSRA


VAERS ID: 1126219 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: SOB, GLOBUS SENSATION


VAERS ID: 1126402 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-18
Onset:2021-03-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Aortic valve incompetence, Aphasia, Arteriogram carotid normal, Cerebral ischaemia, Cerebrovascular accident, Computerised tomogram head, Echocardiogram abnormal, Gaze palsy, Hemiparesis, Magnetic resonance imaging head abnormal, Mental status changes, NIH stroke scale score increased, Neurological examination abnormal, Perfusion brain scan normal, Vertebral artery stenosis, White matter lesion
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 1. gabapentin 100 mg BID 2. levothyroxine 100 mcg daily 3. mirtazapine 15 mg daily 4. rivastigmine 3 mg TID 5. montelukast 10 mg daily 6. pimavanserin 44 mg daily 7. vortioxetine 5 mg daily 8. magnesium oxide 250 mg daily 9. multivitamin 1
Current Illness:
Preexisting Conditions: dementia, parkinsons, asthma, hypothyroidism
Allergies: fish, milk, codeine, penicillin
Diagnostic Lab Data: 3/22 ct brain - negative for hemorrhage 3/22 cta brain - apparent decreased cerebral blood flow and volume along the left parietal region, expected location of the posterior branch of the left middle cerebral artery 3/22 cta neck - no stenosis in the carotid arteries, severe stenosis of the proximal right vertebral artery 3/22 ct perfusion cerebral - negative 3/23 mri brain w/o contrast - punctate diffusion signal intensity within the right frontal periventricular white matter. no corresponding adc focus. this could represent t2 shine through of chronic white matter disease or a very small focus of ischemia. correlate with neurologic assessment. otherwise there is age compatible chronic microvascular change without additional site of potential acute disease. 3/23 echocardiogram - systolic function normal with ef 55-60%; moderate aortic valve regurgitation
CDC Split Type:

Write-up: on 3/22/2021 pt developed altered mental status, right sided weakness, right sided gaze, aphasic. Patient was administered 65 mg IVPB alteplase 3/22 1245 with last known well 3/22 1000. Received Covid vaccine 3/18/21. Pt was usual state of health prior to stroke with no illnesses. initial NIH score was 18. post tpa NIH of 12 am of 3/23.


VAERS ID: 1126432 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-06
Onset:2021-03-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Ear pain, Erythema, Feeling hot, Headache, Scan with contrast, Toothache, Trigeminal neuralgia
SMQs:, Anaphylactic reaction (broad), Demyelination (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Pollen
Diagnostic Lab Data: CT with contrast head (no bone/jaw cancer)
CDC Split Type: vsafe

Write-up: I woke up on 3/7 right ear hurting, head throbbing felt warm with no temp.On 3/10 I went to the school nurse at my employer stated my right ear was red call doctor for antibiotic. I did contact my doctor the symptoms I was exp by then my tooth (bottom right side) was hurting diagnosed trigeminal neuralgia. On last 3/17 my tooth/ear was still exp pain I followed up with my dentist stated he dint see anything. Then on 3/20 I exp a lot of pain went to ER had a CT and concluded I do have trigeminal neuralgia was told to follow up with neuro surgeon.


VAERS ID: 1126472 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Computerised tomogram head, Contusion, Dizziness, Electrocardiogram normal, Fatigue, Headache, Heart rate increased, Laboratory test normal, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: Sinus infection - Augmentin - stopped taking about two days before vaccination
Preexisting Conditions: right ear - narrower Eustachian tube than the left - April 5 - appt to get referral for specialist - it chronically it gets pressure in it and there was fluid in there when I had my sinus infection
Allergies: eurthymyacin
Diagnostic Lab Data: At Hospital - March 16, Tuesday, Bloodwork - normal - liver enzymes weren''t normal but that is from something else EKG test - normal IV - bag of fluids Did a head scan without the dye - normal Except there is fluid in the ear - so ear pressure
CDC Split Type: vsafe

Write-up: Fever - 100.4; body aches; mild headache and fatigue. And then about midweek, I was starting to walk downstairs at work and I had to grab onto rails so I wouldn''t fall - had become so dizzy. I tried to get into my regular doctor - he was full until April 5. I went into walk-in clinic - I had to grab onto a board there (dizzy) and they told me to get to ER. My heart was rapid heart beat by time I got to ER. They had to give me wheelchair so I wouldn''t fall over to go into the ER room. Horrible bruising on wrist - because the first IV didn''t take. They gave me a bag of fluids - and gave me Meclizine to help dizziness subside and two Tylenols for headache. I''m taking 3 (per day)- 25 mg chewable HCI Meclizine. If symptoms aren''t as bad I just take a half of one. Still needing the medication because I still have the pressure in the ear comes up and I need to take the Meclizine and Benadryl to get the pressure to go down.


VAERS ID: 1126649 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-21
Onset:2021-03-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: Patient came in complaining that she was having weakness and dizziness. She was having trouble standing up from seated position. She was also having trouble walking in a straight line. Her husband was with her and drove her to the ER after leaving the pharmacy.


VAERS ID: 1126707 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-21
Onset:2021-03-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: Patient came in to the pharmacy complaining of dizziness and weakness. She was having trouble standing up from seated position and walking in a straight line. Her husband was going to take her to the emergency room after leaving here. I had her smile and it was even. She said that she was ok the day before, but developed these symptoms 2 days after vaccination.


VAERS ID: 1126913 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal X-ray, Activated partial thromboplastin time, Balance disorder, Blindness, Blood creatinine increased, Blood pH, Chest X-ray, Chills, Fatigue, Full blood count, Glomerular filtration rate decreased, Headache, Hypoaesthesia, Hypoxia, International normalised ratio, Lipase, Mental status changes, Metabolic function test, N-terminal prohormone brain natriuretic peptide, Nausea, SARS-CoV-2 test, Somnolence, Troponin T, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: doxycycline 100 MG capsule, tadalafil (ADCIRCA) 20 mg tablet, calcitRIOL 0.25 MCG capsule, warfarin 4 MG tablet, bosentan 125 MG tablet, fluticasone propionate 50 mcg/actuation nasal spray, sevelamer carbonate 800 mg tablet, TORsemide 20 MG
Current Illness: None.
Preexisting Conditions: Pulmonary hypertensive arterial disease associated with congenital heart disease (CMS-HCC), Polycythemia secondary to hypoxia, Kyphoscoliosis, Non-occlusive thrombus, Tricuspid atresia with normal great arteries, Large PDA (patent ductus arteriosus) identified after pulmonary HTN had already occurred (ligated), BT shunt, Dysphonia, Secondary polycythemia, Fuch''s endothelial dystrophy, Holt-Oram syndrome, Hypothyroidism, ventricular septal defect, Epistaxis, S/P PA (pulmonary artery) banding, Chronic kidney disease, stage IV (severe), Hyperphosphatemia, Ascites, etc.
Allergies: None.
Diagnostic Lab Data: HSTNT, ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT), PROTHROMBIN TIME (INR), XR CHEST SINGLE VIEW PORTABLE, Basic Metabolic Panel, PRO-BRAIN NATRIURETIC PEPTIDE, N-TERMINAL (NT-PRO-BNP), Venous Shock Panel, COMPLETE BLOOD COUNT (CBC), TROPONIN T, HIGH SENSITIVITY ED EVALUATION, POC Coronavirus (COVID-19) SARS-CoV-2 Rapid Test, XR ABDOMEN 3 WAY SERIES INCLUDES 1 VIEW CHEST, LIPASE, COMPREHENSIVE METABOLIC PANEL (CMP)
CDC Split Type:

Write-up: 2021-03-20 07:30 PM - chills, 11:00 PM - vomited, 11:30 PM- seen in the Emergency Department 2021-03-21 11:30 AM - fatigue, somnolescence, nausea 2021-03-22 08:00 AM - nausea, 11:30 AM - altered mental status, vision loss, headache, balance problems, numb left arm and hand, hypoxia (SpO2 < 50%), 01:00 PM - seen in the Emergency Department, 03:00 PM Creatinine $g 6.8, eGFR < 10


VAERS ID: 1126931 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Siprol Latoporol lisinopril Prozac fish oil multi vitamin Crestor
Current Illness:
Preexisting Conditions:
Allergies: Bactrum
Diagnostic Lab Data: Blood work Urine test
CDC Split Type: vsafe

Write-up: I got the shot on Wednesday and on Friday I was shivering so bad I thought my chest was going to pop out and so nausea. I called my neighbor and took me to the ER . They ran Blood test and urine test and everything was ok. They told me i was a side effect for the vaccine and sent me home. I went to bed and didn''t feel good, the next day I still didn''t feel good. I got so chilled again and nausea and went back to the ER and say the same Dr. and took my Blood work again and said my blood work was better than the night before. I also had a fever and they told me to take Tylenol and it was just a side effect. I feel so weak and sick at my stomach still.


VAERS ID: 1126940 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine-Benazepril, Atenolol, Buspar, Claritin, Enbrel, Jardiance, Lantus Insulin, Lexapro, Metformin HCL, Multivitamin, Naproxen, Rosuvastatin Calcium
Current Illness:
Preexisting Conditions: Insulin Dependent Diabetes, Depression, Hypertension, Psoriatic Arthritis
Allergies: denies. states she takes a claritin daily for environmental allergies
Diagnostic Lab Data: no labs done. she was given prescriptions for Pepcid and Vistaril
CDC Split Type:

Write-up: states 8 hours after the shot she developed chills, body aches and a sore arm. 24 hours after the shot she developed itching and hives in hands, face and eyes which is what caused her to come to ED.


VAERS ID: 1126941 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-15
Onset:2021-03-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Chest pain, Cough, Dyspnoea, Fatigue, Metabolic function test, SARS-CoV-2 test negative, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol (neb and HFA MDI), benzonatate, cetirizine, diclofenac, epipen, esomeprazole, fluticasone (flonase), fluticasone/salmeterol (advair), guiaiFENesin, linaCLOtide, losartan, meloxicam, montelukast, MVI, olopatadine, oxybutynin, predn
Current Illness: moderate persistent asthma flair, dyspnea on exertion, morbid obesity, GERD, OSA, anxiety / depression, unspecified abdominal pain
Preexisting Conditions: history COVID-19, ovarian cyst, allergic rhinitis, chronic fungal external OM, asthma, migraines, sleep apnea, plantar fasciitis, anxiety and depression, CPAP dependence, gall bladder disease, seborrheic dermatitis, headache, osteoarthritis, constipation, OSA, hypersomnia, vitamin D deficiency, ileitis, small bowel obstruction, dyslipidemia, hypersensitivity syndrome, fatty liver, homelessness
Allergies: codeine, adhesive tape
Diagnostic Lab Data: 3.19.21: 1330 Chest x-ray showed no acute cardiopulmonary abnormalities. Complete blood count is unremarkable. Initial troponin is normal. COVID-19 is not detected. CMP shows a nonfasting glucose of 109 but is otherwise unremarkable. ICg8 shows increased pH of 7.44 with Co2 of 39 but is otherwise unremarkable. 2 hour troponin is normal and -2 delta from baseline. 3.22.21 - see above.
CDC Split Type:

Write-up: Patient with 2 Emergency Department visits after vaccination. (3.19.21 & 3.22.21) 3.19.21: Symptoms: Patient had the J&J vaccine on Tuesday, and felt fatigued on Wednesday. Today she is more short of breath than normal and states she has chest pain. Daughter has suggested an ambulance, but patient, who is A&O X 3, declines. Daughter will bring to ED for evaluation. 61-year-old female with history of asthma, sleep apnea, environmental allergies, and hypertension presents emergency department complaining of shortness of breath and cough that started this morning and midsternal chest tightness rating at a 7/10. Sent home with prescriptions to manage cough, inhaler and steroid burst. 3.20.21 Office Visit: Patient states Wednesday 03/17/21 morning cough and mild fatigue started. Thursday 03/18/21 patient had shortness of breath with exertion x2 days. Yesterday 03/19/21 patient went down the stairs and was having severe shortness of breath. Patient felt like she couldn''t get enough air in. Patient was seen in ED 03/19/21 and prescribed cough medicine. Patient states cough is constant with intermittent coughing fits. Patient was tested for COVID-19 while in ED and results were negative Shortness of breath is still present, but is better after ED visit. Patient states she feels 50% better today 03/20/21. Patient has been using inhaler and prednisone. Patient is needing to move slower to compensate for shortnbess of breath. Cough is present still. Cough is deep and dry. Yesterday 03/19/21 cough was productive. Today 03/20/21 patient is getting a small amount of phlegm out and it is white in color. Denies fever. No known exposure to COVID-19. History of asthma, not much relief currently with inhaler. When shortness of breath is present, it takes patient about 20-30 minutes to recover. Intermittent wheezing with mild wheezing present currently. Tightness in chest is present and coughing makes it worse. Patient had COVID-19 in April of 2020. Any treatment So Far: ED visit, Inhaler, prednisone, and prescribed cough medicines 3.22.21: Mon Mar 22, 2021 1722 This is a 60 year female presents for evaluation of shortness of breath. Some been going on for about a week now. She was just seen in the emergency department 3 days ago for same complaints. At that time she had a cardiac workup that was unremarkable. On initial evaluation here today she appears in no acute respiratory distress. She has normal room air oxygen saturations. Complete blood count shows a slight leukocytosis of 11.93 which may be elevated secondary to her current prednisone use. About 4 positive relative normal limits. Troponin was normal as was her proBNP. COVID PCR was not detected. CT angiogram thorax was negative for PE, pneumonia or other acute process. Patient is notified of these findings. She otherwise is discharged home with instructions follow up closely with primary care physician.


VAERS ID: 1126990 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-06
Onset:2021-03-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Humira
Current Illness: No
Preexisting Conditions: Underlying ankylosing spondylitis
Allergies: No
Diagnostic Lab Data: Blood work, Urinalysis
CDC Split Type: vsafe

Write-up: This happened twice fever went up to 102 for few hours. After going to sleep went away. I went to urgent care nothing seem out of place(lab results).


VAERS ID: 1127001 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / UN

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Myalgia, Pain in extremity, Pruritus, Pyrexia, Rash erythematous, Skin warm, Swelling, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: On march 18 (Thursday)I woke up with fever and muscle pain. But 2 days later I already had fever and my arm were with a " red and hot bump" to much pain and iching..... I went to facility on Saturday at night because I was worst and the doctor told me to don''t worry because It is normal when you got a shot but she never looked to my arm. she went into the room only to give me the diagnostic but without look to my arm. The diagnostic were: adverse reaction to vaccine. I already have the syntoms and tomorrow it will be 1 week since I got the vaccine. I don''t know it is normal. If you want I have pictures.


VAERS ID: 1127077 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-16
Onset:2021-03-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose increased, Cerebrovascular accident, Computerised tomogram head normal, Electrocardiogram abnormal, Hemiparesis, Hyperglycaemia, Hypertension, Hypoaesthesia, Movement disorder, SARS-CoV-2 RNA, Tachycardia, Urine analysis normal, Weight bearing difficulty
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Dehydration (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension diabetes mellitus
Allergies: NKDA
Diagnostic Lab Data: diagnosed in ER with nontraumatic cerebrovascular accident-thrombotic ischemic infarct involving an unknown intracranial artery pt arrived in ER greater than 2 hours since time last known well. TPA was not administered. , Chronic, poorly controlled type 2 diabetes with hyperglycemia, uncontrolled hypertension. patient transferred to higher level of care Hospital.
CDC Split Type:

Write-up: pt presented to ER 0230 3-17-21 pt c/o right sided weakness and numbness, tried to get out of bed and use bathroom and couldn''t bear weight or move his right leg. NIH stroke scale score-2, Glasgow coma score =15 183/105, HR 103, RR 18, 02 saturation 95% RA 98.7 oral temp 0/10 pain. clonidine po tablet 0.1mg. EKG=tachycardia 106 normal P waves, normal PRI, normal QRS complex, normal ST and T waves. labs=SARSCoV2 RNA negative, CT head WO=no acute intracranial abnormality by CT criteria. UA=negative, glucose 359


VAERS ID: 1127237 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-03-08
Onset:2021-03-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Anti factor Xa assay normal, Cardiac perfusion defect, Cardiac stress test abnormal, Chest discomfort, Chest pain, Congestive cardiomyopathy, Dyspnoea, Echocardiogram, Echocardiogram abnormal, Electrocardiogram ST-T change, Electrocardiogram abnormal, Electrocardiogram ambulatory, Extrasystoles, Fibrin D dimer, Glycosylated haemoglobin, Hyperhidrosis, Left ventricular dysfunction, Myocardial infarction, Myocardial ischaemia, Pericardial effusion, Scan myocardial perfusion abnormal, Syncope, Troponin I normal, Unresponsive to stimuli, Ventricular hypokinesia, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Cardiac failure (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Embolic and thrombotic events, arterial (narrow), Malignancy related therapeutic and diagnostic procedures (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), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Tachyarrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: donepezil 10 mg, loratadine 10 mg, memantine 10 mg, omeprazole 40 mg, testosterone 20.25 mg/1.25 grams
Current Illness: none
Preexisting Conditions: malignant melanoma, thrombocytopenia, alzheimer''s dementia, GERD without esophagitis, dyslipidemia, actinic keratoses, adenomatous polyp of colon, erectile dysfunction, male hypogonadism, benign prostatic hypertrophy
Allergies: penicillin, atorvastatin
Diagnostic Lab Data: 3/9/21 and 3/11/21 Chem Profile (blood)- WNL 3/9/21 21:56 Troponin I <0.01; 3/10/21 02:38 Troponin I 0.1 (elevated); 3/10/21 07:52 Troponin I 0.11 (elevated); 3/11/21 06:10 Troponin I 0.03 3/10/21 aPTT 28.5 3/9/21 d-dimer 792 3/10/21 heparin anti-Xa WNL 3/9/21 HgA1C 5.7 3/9/21 12 Lead ECG "NSR with PVCs, nonspecific ST abnormality" 3/10/21 Transthoracic Echocardiogram "left ventricle appears mildly dilated with mild global hypokinesis and estimated ejection fraction 45-50%; grade 1 diastolic dysfunction" 3/11/21 Nuclear Lexiscan Stress Test "abnormal myocardial perfusion study, medium-sized moderate-severity, fixed defect involving the distal inferior, distal septal, and apical segments, consistent with myocardial infarction. Mild peri-infarct ischemia is noted. Abnormal findings low to intermediate risk" 3/11/21 ongoing Holter Monitor placed
CDC Split Type:

Write-up: Pt developed sudden-onset of severe left-sided chest pain with heavy pressure, shortness of breath and diaphoresis; pt collapsed and had a period of unresponsiveness lasting approximately 10 minutes. EMS was called and noted significant ectopy as well as frequent NSVT on ECG. Pt was transported to the Emergency Department and subsequently admitted for observation.


VAERS ID: 1127238 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Cold sweat, Fatigue, Oxygen saturation, 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:
Other Medications: trazodone, atorvastatin, clonazepam, lamotrigine, triamterene/hctz, levothyroxine, montelukast,
Current Illness: unknown
Preexisting Conditions: high cholesterol, mental health disorder, high blood pressure, thyroid disorder
Allergies: none
Diagnostic Lab Data: Blood pressure: 115/75--- 3/23/21 pulse: 66 bpm--- 3/23/21
CDC Split Type:

Write-up: Patient was faint, clammy, tired about 45 minutes after vaccination (patient works at store). Patient was sitting in chair when pharmacist arrived to where patient was working. Patient''s blood pressure and pulse were taken (in normal range). Patient was moved to the floor carefully. 911 had already been called. Patient was monitored until EMTs arrived and took over the scene. Patient was given fluids in the ER and sent home. Patient does have a history of dehydration per patient report.


VAERS ID: 1127263 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dizziness, Dyspnoea, Lacrimation increased, Nasal congestion, Nausea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: GABAPENTIN 600 MG BID PROPRANOLOL 40 MG BID
Current Illness:
Preexisting Conditions: HX: SCLERODERMA ANTISOCIAL PERSONALITY D/O
Allergies: (SUBJECTIVE) ADVIL: HIVES RED WASP: 8 years ago stung by red wasp and had to go to the emergency department
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Monitored for 30 minutes after injection, no symptoms, released back to housing (cell). Approximately one hour later, presented to Health Care Unit with c/o itching, nasal congestion, watery eyes, lightheadedness, nausea, "hard time breathing". Very anxious. Administered 50 mg Benadryl IM without any relief. Patient was sent to local emergency department as precaution. Given epi SQ and additional Benadryl in the emergency department


VAERS ID: 1127318 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-03-14
Onset:2021-03-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Rash, Rash pruritic, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Osela Birth Control - 3-0.03mg; Levothyroxine - thyroid - 137 mcg; Multi-Vitamins; Probiotics
Current Illness: no
Preexisting Conditions: thyroid - hypo
Allergies: no
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: About 24 hours later, I noticed a rash the size of quarter. On Tuesday, the rash was bigger and it was swollen underneath - the lump underneath it was the size of a golf ball. Wednesday and Thursday - Nurse measured it had rash top was 7 cm and the lump underneath was the size of my palm (much bigger). It was really painful and really itchy. On Thursday, I did a telehealth video chat - and I showed it to the doctor and that''s when I went to the clinic where the nurse measured it. Treatment was given: Steroid cream - called Triamcinolone. I used it that night and by the next day the redness had gone down 50% and the lump decrease, also. I have been using it twice a day since Thursday. Today the redness is gone and the lump is maybe the size of a quarter. It''s about 90% better but not completely gone.


VAERS ID: 1127851 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose, Blood pressure increased, Blood test
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: Levothyroxine 75 mg Propanolol 10 mg Ceterizine Aspirin 81
Current Illness:
Preexisting Conditions: Hashimoto''s thyroid disease Heart palpitations on the occasion
Allergies:
Diagnostic Lab Data: Glucose, BUN, Creatinine, BUN/Crea Ration, sodium, potassium, chloride, CO2, anion gap, calcium, protein total, albumin, A/G ration, alkaline, phosphatase AST (SGOT), Bilirubin, GFR (non-african), TSH, Troponin EKG CBC All tests were normal, accept my TSH, that was 5.620
CDC Split Type:

Write-up: Since receiving the Johnson and Johnson Covid vaccine, my blood pressure continued to go up each consecutive day. On Saturday, March 20, 2021 my blood pressure was 195/95. Obviously my husband took me to ER where I was given a prescription to hopefully lower my blood pressure. The medicine that I was give is Amlodipine. My blood pressure typically runs 120''s over low 70''s. I know this issue is not listed on your list of side effects. My husband has also experienced the same issue, just not to the extreme that it affected me. His has been up around 20 points.


VAERS ID: 1128104 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-05
Onset:2021-03-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Headache, Magnetic resonance imaging
SMQs:

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: Calcium, Glucosamine. D3. Collagen peptides, fish oil, Vitamin D, Multi Vitamin, Diclofenac , Formula 7 topical
Current Illness: None
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: MRA
CDC Split Type:

Write-up: Started as a regular headache, Saturday in the afternoon I worked out and the headache got intense, it did not go away. The following Saturday when I worked out, the headache got so much worse; then on that Tuesday when I was working out on the bike, within 2 minutes the headache got so bad, worse headache I ever had and it came on like thunder. I had to sit down for about 40 minutes. I went to an urgent care and got an injection of Ketorolac (Toradol) and ondansetron (Zofran) and they said the headache would go away in about 20 minutes; it has not; I am managing it with Advil but its constant.


VAERS ID: 1128150 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-12
Onset:2021-03-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / UN

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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

Write-up: STROKE 4 days after


VAERS ID: 1128193 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-06
Onset:2021-03-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Computerised tomogram, Echocardiogram, Electrocardiogram, Fear, Magnetic resonance imaging, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: UTI
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Tests done - blood work, CT, chest x Ray MRI echo of heart and ECG - I just want the tingling to go away - please I want a lumbar puncture - please to find out !
CDC Split Type:

Write-up: I have had tingling feelings all over body for 21/2 weeks now ..... I am very scared and have been to the ER twice and they won?t do a lumbar puncture to check for Gillian Barre because my symptoms aren?t bad enough - I don?t want to wait ! This is Very scary


VAERS ID: 1128206 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-12
Onset:2021-03-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood fibrinogen decreased, Cerebral haemorrhage, Cerebral mass effect, Computerised tomogram head abnormal, Disseminated intravascular coagulation, Endotracheal intubation, Fibrin D dimer, Platelet count decreased, Platelet transfusion, Seizure
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metformin, dulaglutide, empagliflozin, atorvastatin
Current Illness: none
Preexisting Conditions: diabetes
Allergies: none
Diagnostic Lab Data: plts 10 pt 13.1 fibrinogen 107 d-dimer 37 ct head 7cm intracerebral hemorrhage with midline shift
CDC Split Type:

Write-up: DIC, intracerebral hemorrhage, intubation, requiring plts transfusion, seizure


VAERS ID: 1128597 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dry mouth, Electrocardiogram, Metabolic function test, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal
Current Illness:
Preexisting Conditions: epilepsy asthma
Allergies: Shellfish
Diagnostic Lab Data: Seen in ED EKG and BMP
CDC Split Type:

Write-up: Pt felt pain in arm, dry mouth, dizzy, lightheaded


VAERS ID: 1128608 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dysarthria, Malaise, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None that we are aware of
Current Illness: None known
Preexisting Conditions: none known
Allergies: Allergy to bee stings
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt had history of anaphylaxis related to bee stings. We asked if he had ever had a reaction to another vaccine and he said no. Pt came up saying he wasn''t feeling well during the observation period, within about 5-10 minutes after receiving the vaccination. He look very pale and clammy. I asked if he was ok and he shook his head. Tried to grab a chair for him and he started to collapse. With some help I was able to get him to the ground without injury. We called 911 and I grabbed an epipen. I tried to assess the patient, and he was unable to tell me if he was having any trouble breathing or if his lips/mouth/tongue was swelling. He was conscious but couldn''t speak coherently. I administered the epipen to his right lateral thigh due to his history of anaphylaxis with bee stings. We were able to lay him down while waiting for the ambulance. His color started to return and he was able to respond to questions, but was still slightly confused. He did tell me at this point that he has had similar reactions after vaccines and blood work. The paramedics arrived and took the patients vitals and took him to the hospital.


VAERS ID: 1129120 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Erythema, Fatigue, Feeling abnormal, Laboratory test, Loss of consciousness, Nausea, Platelet count decreased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Patient had labs drawn 2 days after vaccination, on 3/21 with a platelet count of 116. Repeat labs scheduled
CDC Split Type:

Write-up: Patient passed out 5 minutes after receiving vaccine. 12 hours later the patient had severe chest pain and went to the ED. He received a ketorolac shot there and returned home. 36 hours later, red dots were noticed on the patients feet and ankles (appeared to be petechiae). No other s/sx of bleeding but extreme fatigue, nausea, head fogginess, etc. has been experienced over the past 4-5 days. Patient w/ no PMH of any significance.


VAERS ID: 1129449 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Blood test, Electrocardiogram abnormal, Heart rate irregular, Herpes zoster, Impaired work ability
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 10 mg, levothyroxine 125 mcg, lisinopril 20mg
Current Illness: No
Preexisting Conditions: High blood pressure, inactive thrpyroid
Allergies: No
Diagnostic Lab Data: Blood work. 3/16/2021 4 EKG,s. 3/16/2021; 3/16/ 2021; 3/17/ 2021- 100 %. Atrial fibrillation Blood pressure
CDC Split Type:

Write-up: Shingles- on head, scalp, face - treatment valacyclovir, lost of 10 teaching days, Atrial fibrillation - irregular heart beat, 4 EKG ?s, 1 physicians care facility, 1 emergency room visit, 1 urgent care facility, 1 phone call to family doctor, 1 visit to Dr. cardiologist , suppose schedule of a cardiac stimulus procedure ; treatment apixaban and metoprolol


VAERS ID: 1129477 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-08
Onset:2021-03-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash pruritic
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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Tartrate 50 mg. 1 tablet twice a day Levothyroxine 25 mcg 1 tablet a day Famotidine 20 mg 1 tablet twice a day Eliquis 5 mg 1 tablet twice a day Vitamin B-12 500 mcg 1 tablet a day Vitamin D3 50 mcg (2000 IU) 2 pi
Current Illness: None
Preexisting Conditions: Heart disease (Pacemaker, valve repair surgery) High cholesterol
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bad itchy rash on legs, arms, torso


VAERS ID: 1129508 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-14
Onset:2021-03-19
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Antipsychotic drug level, Full blood count, International normalised ratio, Limb discomfort, Pain in extremity, Peripheral swelling, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine HCL ER Nitroglycerin Omeprazole Lithium Ventolin HFA Vitamin D Calcium Carb
Current Illness: Reflux Disease Asthma Osteoporosis Depression/Anxiety
Preexisting Conditions: Reflux Disease Asthma Osteoporosis Depression/Anxiety
Allergies: Sulfa Decongestants
Diagnostic Lab Data: Lab Reports done in ER on 3/21/21 (CBC, metabolic profile, sed rate, PT/INR, APTT, lithium level.) Discharge papers notes no significant metabolic abnormality.
CDC Split Type:

Write-up: Received the J+J Janssen vaccine on Sunday 3/14/21. On Friday 3/19/21 developed bilateral lower leg discomfort and red spots on outer part of shin. On Sunday 3/21/21 noted increase in swelling both feet and lower legs with pain and rash waist down. Patient went to ER for evaluation. Started on prednisone. Dx: Vasculitis On Monday 3/22/21 evaluated by PCP. Follow up blood work and office appointment in 8 to 10 days. Report to VEARS. Awaiting patient call back to complete form. On Wednesday 3/24/21 patient returned call. Reports joint aches, right side decreased swelling, left foot and hand remains slightly swollen. Purple skin discoloration remains on lower extremities but decreased pain. VEARS form submitted.


VAERS ID: 1129904 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Tremor, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol (PROVENTIL HFA;VENTOLIN HFA;PROAIR HFA) inhaler ALPRAZolam (XANAX) 0.5 MG tablet amLODIPine (NORVASC) 5 MG tablet atorvastatin (LIPITOR) 20 MG tablet busPIRone (BUSPAR) 5 MG tablet diphenhydrAMINE (BENADRYL) 25 mg capsul
Current Illness: none
Preexisting Conditions: Essential hypertension, benign (*) Sleep apnea Migraine headache (*) Asthma (*) Pure hyperglyceridemia (*) Generalized anxiety disorder (*) Controlled type 2 diabetes mellitus with renal manifestation (*) Hyperlipidemia Proteinuria Controlled type 2 diabetes mellitus without complication (*) MDD (major depressive disorder), recurrent severe, without psychosis (*) Panic disorder without agoraphobia (*)
Allergies: CodeineHives Contrast [Iodinated Contrast Media]Hives Darvon [Propoxyphene]Hives ErythromycinNausea And Vomiting Hydrocodone PiroxicamOther (See Comments) Garamycin [Gentamicin]Rash Monistat 1 [Tioconazole]Rash PropranololRash Sulfa (Sulfonamide Antibiotics)Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced lightheadedness, spots in vision, and shakiness approximately 30 mins after receiving the vaccine. Was monitored for 25 mins with no resolution in symptoms and was sent to the emergency room for additional evaluation.


VAERS ID: 1129966 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN HRS1805031 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Faeces discoloured, Full blood count, Laboratory test, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Diphenhydramine 12.5mg, milk of magnesia
Current Illness: Constipation Atopic dermatitis
Preexisting Conditions: allergies Dermatitis Fibromyaligia
Allergies: Non seroid anti-inflammatory drugs, aspirin, tomatoes, and sensitive to many products
Diagnostic Lab Data: Chemistry panel, cbc 03/18/2021
CDC Split Type:

Write-up: loose green stools for 3 days, then slowly progressed to right upper quid pain after eating , nausea, navel pain, loose stool at times Have not resolved


VAERS ID: 1130047 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-15
Onset:2021-03-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis combigan vitamin d coq10 vit b12 cardizem cd trusopt lexapro cozaar nitrostat prilosec actos crestor
Current Illness:
Preexisting Conditions:
Allergies: barbituates codeine penicillins
Diagnostic Lab Data: pending
CDC Split Type:

Write-up: 3/24/21 eval of dizziness . States sx started this morning . Was in hospital and transferred approx. 1 week ago for dehydration and a-fib. Denies nausea or vomiting.


VAERS ID: 1130201 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-14
Onset:2021-03-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Blood pressure increased, Chills, Condition aggravated, Decreased appetite, Dry mouth, Full blood count normal, Headache, Insomnia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Arthritis (broad), Hypoglycaemia (broad), Dehydration (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: Trelegy, Hydrochlorothiazide, Zyrtec, Xiidra, Dorzolomide Hydrochloride-Timolol, Advil, Passion flower, Garlic, Biotin, Cal Mag Zinc, B12, D3, Allergy shot immunotherapy
Current Illness: None
Preexisting Conditions: Arthritis, Allergies, Hypertension
Allergies: Shellfish, Aspirin, Dogs, Cats, Tres, Grasses, Mold
Diagnostic Lab Data: CBC normal
CDC Split Type:

Write-up: Elevated blood pressure 230/170 for over 24 hours. Dry mouth, Feeling of unease. Chilled, Insomnia. Loss of appetite. Joint pain, Headache for 6 days.


VAERS ID: 1130313 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Lip swelling, Peak expiratory flow rate decreased, Pruritus, Respiratory tract irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol 12.5 MG tablet Commonly known as: Coreg Take 2 tablets (12.5 mg) by mouth daily with food Amlodipine 5 MG tablet Commonly known as: Norvasc Take 1 tablets (5 mg) by mouth daily. Rosuvastatin 40 MG tablet Commonly known as: Cre
Current Illness: None
Preexisting Conditions: Asthma High Blood Pressure Fibrmyalgia
Allergies: Orange (Fruit) Losartan Hydrochlorothiazide Shrimp (Diagnostic)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About 45 minutes after receiving my Covid vaccine I noticed my lower lip started to swell there was no swelling in my throat). I took Benadryl. I needed to continue taking the Benadryl every 4 - 6 hours because the swelling kept coming back. Later I noticed my lungs getting scratchy. I started using my nebulizer to stay ahead of it. I took two Benadryl before going to sleep. When I woke up I noticed my lips starting swell up again and my lungs were still scratchy. I took my peak flow and it have dropped to 345 (my normal is about 375/380). I contacted my Pulmonologist and her recommended that I go to Urgent Care and report my reaction to the CDC. I went to the Urgent Care. The doctor told me to continue with the Benadryl and nebulizer treats and she also added Pepcid and Prednisone. It is now one week out and I am still experiencing the lip swelling and itchiness on my face so I am still currently taking the Benadryl. From time to time my lungs my lungs feel scratchy.


VAERS ID: 1130391 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-11
Onset:2021-03-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Laboratory test, 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:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 03/12/21 labs and ECG
CDC Split Type:

Write-up: syncope the morning after vaccination


VAERS ID: 1130392 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Influenza virus test, Pain, Pyrexia, SARS-CoV-2 test, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Nail Patella Syndrome
Allergies: Morphine, Dramamine, IV contrast dye, Gluten, Kiwi fruit
Diagnostic Lab Data: Blood test, Urinalysis, Flu test, COVID test (03/23/2021)
CDC Split Type:

Write-up: By 4 pm, the body aches turned into a high fever and went to the emergency room at 8 pm with a fever of 105.5. I was given 2 bags of cold saline IV and it dropped to 101 and they released me. Janssen COVID-19 Vaccine EUA


VAERS ID: 1130413 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Rash pruritic, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: TB test - whole arm swelled up; previously (30 years ago) - same reaction to food - Citric Acid
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Citric Acid
Diagnostic Lab Data: medications given in the ER at 3:00am on Sunday, 3/21 - Mylanta, Benadryl, Pepcid, Solu-Medrol
CDC Split Type:

Write-up: After a few hours, broke out in an itchy rash, felt pressure in the chest and back of the throat. broke out in hives


VAERS ID: 1130449 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-24
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Amylase decreased, Aspartate aminotransferase normal, Basophil count decreased, Basophil percentage, Bilirubin urine, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride normal, Blood creatine phosphokinase MB normal, Blood creatine phosphokinase normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Blood urine present, Brain natriuretic peptide increased, Bronchiectasis, Carbon dioxide decreased, Chest discomfort, Chromaturia, Computerised tomogram thorax, Cough, Drug screen negative, Dyspnoea, Eosinophil count decreased, Eosinophil percentage, Eructation, Fibrin D dimer normal, Gastrooesophageal reflux disease, Glomerular filtration rate normal, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Haemoptysis, Influenza virus test negative, Lipase normal, Lung opacity, Lymphocyte count normal, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume increased, Monocyte count normal, Monocyte percentage increased, Neutrophil count increased, Neutrophil percentage, Nitrite urine absent, Palpitations, Platelet count normal, Protein total normal, Protein urine absent, Red blood cell count normal, Red blood cells urine, SARS-CoV-2 test, Scan with contrast abnormal, Specific gravity urine, Troponin I increased, Urinary sediment present, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine increased, White blood cell count increased, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? aspirin 81 MG EC tablet, Take 81 mg by mouth Nightly, Disp: , Rfl: ? atorvaSTATin (LIPITOR) 20 MG tablet, Take 20 mg by mouth Nightly, Disp: , Rfl: ? gabapentin (NEURONTIN) 300 MG capsule, Take 1,200 mg by
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CTA Chest For Pulmonary Embolism w Contrast [245598176] Collected: 03/23/21 0139 Order Status: Completed Updated: 03/23/21 0215 Narrative: EXAM DESCRIPTION: CT CHEST ANGIOGRAPHY WITH IV CONTRAST CLINICAL INFORMATION: Age: 58 years Gender: Male Indication: Shortness of breath Additional history: Hemoptysis COMPARISON: None. TECHNIQUE: Procedure: CT Angiography of the Chest Protocol: Pulmonary embolus Reformats: Coronal and sagittal Intravenous Contrast: 80 mL Omnipaque 300 without documented adverse reaction Image Quality: Adequate Multiple coronal computer generated 3D reconstructions (MIPS) of the pulmonary arteries were included. This exam was performed according to our departmental dose optimization program, which includes automated exposure control, adjustment of the mA and/or kV according to patient size and/or use of iterative reconstruction technique. Dose Range: Up-to-date CT equipment and radiation dose reduction techniques were employed. FINDINGS: Pulmonary arteries: No pulmonary embolus Lungs and pleura: Mild right basilar groundglass airspace opacities and mild bronchiectasis is seen.. Heart: Normal heart size. No pericardial effusion . Aorta: Normal Mediastinum and hila: Normal Chest wall: Normal Lower neck: Normal IMPRESSION: Negative for pulmonary embolus. Mild right basilar bronchiectasis and mild groundglass airspace opacities which may represent atypical infection versus pulmonary contusion in the setting of trauma. Electronically signed by: MD 3/23/2021 2:13 AM CDT Influenza antigen [245598168] Collected: 03/23/21 0149 Order Status: Completed Specimen: Nasopharyngeal Updated: 03/23/21 0214 Influenza A NEGATIVE NEGATIVE Influenza B NEGATIVE NEGATIVE NOVEL CORONAVIRUS SARS-COV-2 BY PCR [245598178] Collected: 03/23/21 0150 Order Status: Sent Specimen: Nasopharyngeal Updated: 03/23/21 0200 Urine Drug Screen Medical - 10 Panel [245598187] Collected: 03/23/21 0118 Order Status: Completed Specimen: Urine Updated: 03/23/21 0143 Amphetamines Screen, Urine NEGATIVE NEGATIVE Barbiturate Screen, Urine NEGATIVE NEGATIVE Benzodiazepine Screen, Urine NEGATIVE NEGATIVE Cocaine Metabolites Urine NEGATIVE NEGATIVE Methamphetamine, UR NEGATIVE NEGATIVE Methadone Screen, Urine NEGATIVE NEGATIVE Opiate Screen, Urine NEGATIVE NEGATIVE Oxycodone Scr Qual,UR NEGATIVE NEGATIVE Phencyclidine Screen Urine NEGATIVE NEGATIVE Propoxyphene NEGATIVE NEGATIVE THC NEGATIVE NEGATIVE TCA - Tricyclic Antidepressants Urine, Qualitative NEGATIVE NEGATIVE Urinalysis with reflex to culture, if indicated [245598186] (Abnormal) Collected: 03/23/21 0119 Order Status: Completed Specimen: URINE,CLEAN CATCH (CCMS) Updated: 03/23/21 0139 Glucose UA NEGATIVE NEGATIVE MG/DL Protein UA NEGATIVE NEGATIVE MG/DL Bilirubin UA NEGATIVE NEGATIVE Urobilinogen UA 0.2 0.2 - 1.0 MG/DL pH UA 5.0 5.0 - 8.0 Blood UA TRACEAbnormal NEGATIVE Ketones UA NEGATIVE NEGATIVE MG/DL Nitrite UA NEGATIVE NEGATIVE Leukocyte Esterase UA NEGATIVE NEGATIVE UR Appearance CLEAR CLEAR Specific Gravity UA <1.006 1.000 - 1.030 Color YELLOW YELLOW Site CCMS Comment, Urine Culture NOT INDICATED RBC Urine 0 to 5 <3 /HPF WBC Urine 0 to 5 <5 /HPF Squamous Epithelial RARE <5 /HPF D-dimer, quantitative [245598173] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0137 D-Dimer 244 0 - 400 NG/ML FEU Brain Natriuretic Peptide (BNP) [245598172] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0137 B-Type Natriuretic Peptide 110High 0 - 100 PG/ML Magnesium [245598167] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Magnesium 1.7Low 1.8 - 2.4 MG/DL CKMB [245598170] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Creatine Kinase-MB 1.7 0.0 - 3.6 NG/ML Troponin Series [245598171] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Troponin I 0.03 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. Comprehensive metabolic panel [245598164] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Glucose 136High 65 - 100 MG/DL Blood Urea Nitrogen 13 7 - 18 MG/DL Creatinine 0.9 0.7 - 1.3 MG/DL Sodium 138 136 - 145 MMOL/L Potassium 3.9 3.5 - 5.1 MMOL/L Chloride 100 98 - 107 MMOL/L Co2 21 21 - 32 MMOL/L Calcium 8.5 8.5 - 10.1 MG/DL Protein Total 7.6 6.4 - 8.2 G/DL Albumin 4.0 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 64 46 - 116 U/L Alt (SGPT) 43 16 - 63 U/L AST(SGOT) 21 15 - 37 U/L Bilirubin, Total 0.5 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR $g90 $g90 ML/MIN/1.73sq.m Amylase [245598165] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Amylase 40 25 - 115 U/L Lipase [245598166] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Lipase 92 73 - 393 U/L CK (CPK) Creatine Phosphokinase [245598169] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Creatine Kinase Total 124 39 - 308 U/L CBC w Auto Diff [245598163] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0117 White Blood Cell Count 11.7High 4.8 - 9.6 THOUS/uL Red Blood Cell Count 5.18 4.33 - 5.59 MIL/uL Hemoglobin 15.6 13.1 - 16.8 GM/DL Hematocrit 46.0 38.8 - 49.0 % Mean Corpuscular Volume 88.8 82.7 - 94.4 FL Mean Corpuscular Hemoglobin 30.1 27.7 - 32.6 PG Mean Corpuscular Hemoglobin Conc 33.9 32.4 - 35.7 G/DL Rdwcv 12.9 11.6 - 13.9 % Rdwsd 42.5 36.0 - 46.1 FL Platelet Count 198 154 - 364 THOUS/uL Mean Platelet Volume 11.4 8.7 - 11.7 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 68.8High 34.0 - 67.9 % Lymphs 18.0Low 19.1 - 41.2 % Monocytes 10.0 6.1 - 12.3 % Eos 1.7 0.9 - 7.6 % Basos 0.9 0.2 - 1.5 % Neutrophils Absolute Count 8.1High 2.7 - 5.8 THOUS/uL Lymphocytes Absolute Count 2.1 1.1 - 3.3 THOUS/uL Monocytes Absolute Count 1.2High 0.4 - 0.9 THOUS/uL Eosinophils Absolute Count 0.2 0.1 - 0.6 THOUS/uL Basophils Absolute Count 0.1 0.0 - 0.1 THOUS/uL Imm Gran 0.6 0.2 - 0.9 % Abs Imm Gran 0.07 0.0 - 0.1 THOUS/uL
CDC Split Type:

Write-up: 3/24/21 ER HPI: 58 y.o. male who presents with shortness of breath, palpitations, chest pressure, and hemoptysis. Patient has known history of atrial fibrillation and coronary artery disease. Patient reports he was out in his yard approximately 1 hour ago this evening picking up some items when he bent over and started feeling palpitations. Patient states the palpitations caused a pressure in the center of his chest. He then became short of breath. He then states he got into a coughing fit and coughed up some blood. Patient states he knew something was not right so he told his wife to bring him to the ER. Currently here in ER patient continues to complain of palpitations and trash pressure. Patient currently gives his pain as 6/10. It is nonradiating. Patient reports shortness of breath but denies any lightheadedness, dizziness, nausea, vomiting, or diaphoresis. Of note, patient reports he has been having acid reflux and belching tonight. He states his wife had given him two Pepcid earlier.


VAERS ID: 1130512 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-19
Onset:2021-03-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was in observation and had witnessed syncopal event. Is prediabetic and had not eaten that day. Witnessed by nurse. 911 called, assessed and transported to hospital.


VAERS ID: 1130574 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Reported sandpaper like feeling in throat, n/v


VAERS ID: 1130579 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chills, Computerised tomogram head, Dizziness, Fatigue, Headache, Paraesthesia, Pyrexia, Tunnel vision
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Retinal disorders (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flintstones Vit
Current Illness: No
Preexisting Conditions: Afib (once a year)
Allergies: Gluten
Diagnostic Lab Data: CT Brain, Blood work
CDC Split Type: vsafe

Write-up: I had chills, fever, headache, extreme tiredness, almost passed out and tingling on right side arm/leg. When I almost passed out felt like tunnel vision.


VAERS ID: 1130654 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-12
Onset:2021-03-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Diarrhoea, Dry mouth, Oropharyngeal pain, Palpitations, Pharyngeal swelling, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 3/12/21 day of injection The patient got the Johnson & Johnson Covid vaccine this afternoon around 1400, after which he noted a red, itchy rash on his chest, back, and bilateral upper extremities. He also notes a dry mouth and mild throat swelling, but denies shortness of breath, vomiting, lightheadedness, chest pain. He took benadryl about an hour after getting the vaccine without any improvement.. He states that amoxicillin is the only medication to which has had an allergic reaction. On 3/12/21 He was s treated with Vistaril 50 mg, Deltasone 50 mg, and epinephrine 0.3 mL. The medications relieve most of his symptoms for 2 hours before it returned along with having developed a sore throat and sensation of swelling to his throat. On 3/13/21 at 0139am patient returned to ED for further evaluation. Patient remedicated with benadryl, epinephrine and was given pepcid. On 3/14/21 at 1430 patient again seen in ED for further evaluation with worsening rash. patient that last night he had a severe allergic reaction and self administered epinephrine at 0440. This morning he woke up with a worsening rash that he describes as burning. He reports a sensation of throat swelling. He has had 3 episodes of diarrhea, but no nausea or vomiting. Yesterday, patient states that his heart was "racing" but denies any chest pain. He states that every time his rash is treated, it returns and is worse in severity


VAERS ID: 1130967 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Blood test, Chills, Computerised tomogram head, Disturbance in attention, Dizziness, Nausea, Retching, Urine analysis, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbalta Lisinopril/HCTZ Coreg Vitamin D Vitamin C Elderberry Zinc, Calcium, Magnesium Vitamin Flonase Nasal Spray Famotidine Vistiril (prn for Chronic hives)
Current Illness:
Preexisting Conditions: Chronic hives Hypertension controlled with medication Racing heart Controlled with medication Chronic arthritis pain Controlled with medication Allergies
Allergies: Bleomyacin (Chemo drug 2015) Sensitivity to Peanuts(hives) Environmental allergies (cats, mice)
Diagnostic Lab Data: Called my doctor''s office and reported my symptoms yesterday(Tuesday). They advised me to go to ER and be screened for possible stroke. ER Visit 3/23/21 CT Scan of head Blood Work Urinalysis Physician brief neuro evaluation Today 3/23/21 Epily manuever to alleviate dizziness
CDC Split Type:

Write-up: Cold chills Friday afternoon and night(but consider those the mild side effects) Saturday morning noticed: dizziness with movement(like motion sickness); nausea has continued since then(Sat, Sun, Mon, Tues, Wed) Dizziness has been severe and causing nasea with gagging but not vomiting. Feeling off balance, using walls etc in order to walk straight. Blurred vision (comes and goes as dizziness increases/decreases) Difficulty concentrating. Yesterday(Tuesday) pulling sensation down right side of neck, confusion, blurred vision. Slight hesitation to writing with right hand(had to concentrate to sign my name etc)


VAERS ID: 1131376 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-09
Onset:2021-03-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Seizures 4 days after the vaccine


VAERS ID: 1131536 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-19
Onset:2021-03-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Electrocardiogram normal, Respiration abnormal
SMQs:, Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Respiratory failure (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: Omeprazole DR - 40 MG
Current Illness: Migraines
Preexisting Conditions: None
Allergies: None just lactose intolerant
Diagnostic Lab Data: Went to ER 3/23/21 and had a chest X-ray and EKG and everything looked normal and they said my lungs sounded normal. But doesn?t feel like that.
CDC Split Type:

Write-up: Have had some chest pain for a few days and different breathing. Doesn?t feel like my normal breathing just feels more restrictive than normal.


VAERS ID: 1417385 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-19
Onset:2021-03-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Swollen tongue, Tongue erythema, Tongue pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Narrative: Pt did have hx of allergies and carried epi pen. We did consult provider, who ordered 50 mg diphenhydramine 15 min prior to vaccine administration. Approx 20 minutes post vaccine pt reported "itchy, swollen tongue" and significant swelling/redness was visualized. Pt taken to nurse exam room, 0.3 mg epinephrine administered, VS obtained, 02 NC applied, and 911 called for transport to hospital for further observation. Pt stable at time of transfer.


VAERS ID: 1417391 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-14
Onset:2021-03-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK LA / IM

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

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

Write-up: muscle spasms/cramping of L side entire body Narrative:


VAERS ID: 1131785 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Heart rate increased, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), 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:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizziness; increased heart rate, increased blood pressure, shaking


VAERS ID: 1131790 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-15
Onset:2021-03-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram, Full blood count, Metabolic function test, Peripheral swelling, Rash, Swelling face, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC, CMP, CT abd without worrisome findings
CDC Split Type:

Write-up: Rash, abdominal pain, vomiting, facial and hand swelling


VAERS ID: 1131797 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cranial nerve paralysis, Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Benicar, pravastatin, insulin humalog, aspirin, gabapentin
Current Illness:
Preexisting Conditions: CVA DM HLD HTN
Allergies: morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right Unilateral Cranial Nerve 7 Paralysis, 6 hours after administration of vaccine, associated symptoms included diarrhea, emesis Treatment included prednisone and valacylovir


VAERS ID: 1132049 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

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

Write-up: Patient experienced perspiration, dizziness, and fainting with no loss of consciousness. Patient was talking and answering questions appropriately. B/P 120/80, FSBS 131 @ 1:52PM. EMS was notified and Patient was transported to local hospital. I spoke with the patient today and he states he was discharged from hospital and everything was fine. He states he is doing good today.


VAERS ID: 1132411 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Eating disorder
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: 3/25/21 To er for eval of cough, chills, shortness of breath x 2 days. States he had Covid January 2020 that left his lungs in " bad condition". Had his Johnson and Johnson Covid vaccine 2 weeks ago. Has not been drinking or eating much in the last 2 days


VAERS ID: 1132422 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chest X-ray normal, Computerised tomogram head, Electrocardiogram normal, Influenza virus test negative, Laboratory test normal, Migraine, Pain, Pyrexia, Respiratory syncytial virus test negative, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Tartrate, multi-vitamin, vitamin D, Tylenol
Current Illness: None
Preexisting Conditions: Frequent headaches
Allergies: Penicillin
Diagnostic Lab Data: March 24?ER doctor did a stroke assessment and that was negative. Was tested in the ER for covid, flu and rsv. All were negative. ER did blood work, chest X-ray, EKG, and a CT scan of my head and all came back fine.
CDC Split Type:

Write-up: March 23 about 7pm I started with stomach upset, then had body aches and then had a migraine start about 10pm. Went to the ER the next day to be treated for the stomach upset and migraine. Found out I had a fever of 101 degrees. Was treated with a few medications. Migraine subsided a little bit and then I was sent home. It is now almost 48 hours post-covid vaccine and I still have a headache.


VAERS ID: 1132777 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-20
Onset:2021-03-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, 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), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: losartan 100/12.5 mg qd, Norvasc 10 qd, carbamezapine chew 1.5 mg bid, celexa 10mg qd , Toprol 50mg qd , timolol 0.25 1 drop left eye bid
Current Illness:
Preexisting Conditions: blind, heart palpitation
Allergies: Claritin and pcn
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: They found her unconscious and rushed to ER and MRI showed mild stroke


VAERS ID: 1132787 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-06
Onset:2021-03-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Laboratory test, Magnetic resonance imaging, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Oxcarbazapine, ziprasadone
Current Illness: None
Preexisting Conditions: Schizoaffective disorder
Allergies: Hydroxozone
Diagnostic Lab Data: Mri/ct scans 3/21/21 Awaiting lab results
CDC Split Type:

Write-up: Within a week of getting the vaccine I developed a blood clot in the lining of my stomach


VAERS ID: 1132846 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-10
Onset:2021-03-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Catheterisation cardiac normal, Chest X-ray normal, Computerised tomogram head normal, Dizziness, Echocardiogram abnormal, Electrocardiogram normal, Laboratory test normal, Magnetic resonance imaging head normal, Stress cardiomyopathy, Tilt table test positive, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Hypertension (narrow), Cardiomyopathy (narrow), Other ischaemic heart disease (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: RX: Synthroid 88 mcg; Klor-Con 10mg (qid); Atorvastatin 20 mcg OTC: Probiotic; AZO Cranberry; Zinc 50 mg; D3 5,000 IU;Magnesium 500 mg; Qunol 100 mg; Fish Oil 1,000 mg
Current Illness: None known
Preexisting Conditions: Hypertension, Hypothyroidism, Hypokalemia, Hypercholesterolemia
Allergies: Codeine; Tetracycline
Diagnostic Lab Data: 3/14: Multiple EKG - normal; Labs - mostly normal in ER, but Tryponin level peaked at 5.78; CXR - normal; CT of brain - Normal 3/15: Echocardiogram - "Broken Heart Syndrome", Cardiac Cath - Clear Arteries; MRI brain - Normal
CDC Split Type:

Write-up: 3-13 developed dizzyness with room spinning, cleared after 1 hour of additional sleep. 3-14 repeat of dizzyness with room spinning, did not clear. Diastolic B/P elevated from 87 to 107 mmHg; Systolic from 143 to 166 mmHg; Tilt Test Positive. Symptoms onset around 0715 hrs and lasted until 1600 hrs when EMS called and taken to Hospital


VAERS ID: 1133185 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1085029 / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Periorbital swelling, Pruritus, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: N/a
Diagnostic Lab Data: Employee was escorted to Emergency Room for further evaluation. States that she was given steroid injection and then prescribed oral steroid taper pack.
CDC Split Type:

Write-up: Approximately 15 minutes after receiving dose of vaccine, employee states that she began to itch all over. Eyelids and periorbital area began to swell. She did not experience any shortness of breath or difficulty swallowing.


VAERS ID: 1133329 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fall, Loss of consciousness, Skin abrasion
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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt began to feel lightheaded. Stood up to call nurse then lost consciousness, falling to the ground, scraping his face on the concrete. Pt had facial abrasions. Was transported to Urgent Care.


VAERS ID: 1133714 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea, Feeling abnormal, Headache, Hyperhidrosis, Hypopnoea, Pallor, Rhinorrhoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unknown. Had reaction to tetanus but pt did not specify the type.
Other Medications: Do not have this information and patient did not answer phone.
Current Illness: none reported at vaccine clinic
Preexisting Conditions: None reported at vaccine clinic. Pt will not answer phone to answer these questions.
Allergies: tetanus, penicillin
Diagnostic Lab Data: Hospital records have been requested
CDC Split Type:

Write-up: 1018 Janssen vaccination given to left deltoid per LPN. 1031 Pt reported "my head started hurting". 1033 Pt reported "my headache is getting is getting worse. It''s starting to pound. I''m a little dizzy". No other symptoms reported at that time. 1035 Pt reported "my nose is starting to pour water and my headache is getting worse. I''m getting more dizzy". Respirations even/unlabored. No tightness of chest or throat. No swelling or rash. 1036 Benadryl 25mg (two tabs) given PO by FNP. Pt was able to swallow pills adequately. Reported "I always have trouble swallowing pills". 1037 Pt was assisted out of vehicle to chair beside her truck for better monitoring. BP 120/72, HR 96. Unable to pick up SaO2 on O2 sat monitor. She was speaking in full sentences. She reported "I need to throw up". Ice pack placed on back of neck. Stated that ice pack felt good. 1038 Trash can given for her to vomit in. Pt sitting up in chair. AAO x3. 1039 She reported "I don''t feel right. My head is pounding. I feel like I can''t catch my breath". EMS called immediately. Respirations were rapid, 30, mildly labored. Lungs CTA but breathing shallow. 1040 EpiPen auto-injector 0.3mg (1st dose) given IM left thigh by FNP. Pt was dry heaving and spitting out saliva in trash can. Reported "this is the worst headache of my life". Respirations mildly labored 1043 Pt developed dry cough, continued to have rapid respirations. Encouraged to slow breathing down and to breath deeply. Reported "still not feeling right". Pt became diaphoretic and pale. 1045 Pt''s breathing became more labored and rapid with respirations 34. When asked if her throat was tight, she nodded to indicate yes. 1046 EpiPen auto-injector 0.3mg (2nd dose) given IM left thigh per FNP. Pt continued to breath rapidly, shallow. Pt unable to speak. When asked if she could breath, she shook her head no and began pounding on her chest with her hands. Ambulance arrived. 1049 Pt was assisted to ambulance gurney. Pt was able to assist with transfer. Reported "my head is hurting so bad". Respirations were less labored. Pt transferred to ambulance per EMS staff.


VAERS ID: 1134120 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Bursitis, Chills, Erythema, Gait disturbance, Headache, Joint swelling, Monocyte count increased, Myalgia, Pain, Pyrexia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Mag, Probiotic, Multi Vie Famotidine: One Tab in the morning 40mg
Current Illness: N/A
Preexisting Conditions: Irritable Bowel Syndrome (IBS)
Allergies: Allergies: Nickel, Cobalt, Biotin; Products containing such.
Diagnostic Lab Data: Within 24 hour (next evening) swelling in knee, Pain, redness. Painful to touch. Limping. Diagnosis: Bursitis. Elevated Monocytes elevated. 15.6 gm/dl.
CDC Split Type:

Write-up: Patient received Vaccine March 10 at 8am, Couple hours (10am) headache, muscle aches, Low Grade fever 38.4 chills. Lasting for the remainder of the day and symptoms dissipated next morning


VAERS ID: 1134439 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Dizziness, Dysstasia, Electrocardiogram, Heart rate increased, Hypertension, Magnetic resonance imaging, Seizure, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: clonidine, Clonopin, deplin, gabapentin, Np thyroid, Progesterone
Current Illness: CPTSD, anxiety disorder, Cushing''s syndrome, pots
Preexisting Conditions: CPTSD
Allergies: na
Diagnostic Lab Data: 03/17/21 MRI, chest Xray, blood draws, EKG
CDC Split Type:

Write-up: I received the shot at the pharmacy location, they had us sit for about 10min after then we could go, my next appointment happened to be at a dr''s office thank goodness because about 10 min after sitting in the waiting room I felt faint and spoke out to the receptionist that I needed to lie down, they laid me down on the couch where I was sitting my blood pressure had shot up to 165/126 or I was unable to stand on my own, I was beginning to convulse and my heart rate shot up, they got a wheel chair, put me in it and took me back to one of their rooms where they I think ran a few test and then they made the decision to take me down to the er, the er which I told repeatedly that I had just received the covid shot, they hooked me up to machines, I think did a EKG, wheeled me to get a mri, and then did a chest xray, all while I was convulsing, they allowed this convulsing to continue for over 3+ hrs before they finally gave me something to calm down the convulsions, I was having sensory issues and could not handle, light, etc, for the next many days my heart rate would jump from the 60''s too the top was I think 200BPM, I had to lie in a dark room, no sounds for a few days, I am just now felling a little bit better.


VAERS ID: 1134581 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-17
Onset:2021-03-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1608609 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Doxycyline, eye drops, Vitamin D3, Vitamin C, Multivitamin, Probiotic, NAC
Current Illness:
Preexisting Conditions: Bronchiectasis and Glaucoma
Allergies: Levoquin, Cefdinir
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed hives all over my torso and arms that continued through today (3/25). Went to ER and was given IV steroids, Benadryl and Pepsid and steriods to take at home for 4 days. Have never had a hive episode like this before.


VAERS ID: 1134642 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Confusional state, Dry skin, Head injury, Loss of consciousness, Musculoskeletal stiffness, Pallor, Skin warm, Vital signs measurement
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None per patient
Current Illness: None per patient
Preexisting Conditions: None per patient
Allergies: None per patient
Diagnostic Lab Data: Unknown. Patient transported by EMS to hospital.
CDC Split Type:

Write-up: Patient received Janssen COVID-19 vaccine at 123pm on 3/25/2021. Patient directed to observation area and fell backwards out of chair at 127pm on 3/25/2021. After falling backwards out of chair patient had a full body stiffening episode and was noted to be bleeding from his head. Bleeding controlled with gauze held by an RN. Patient initially GCS 13 and unable to answer questions appropriately, manual blood pressure 118/60 HR 50 SpO2 89% on room air, patient pale and dry. Patients legs raised by RN and pressure to laceration on top of forehead continued to be held by RN. After 5-7 minutes patient GCS increased to 15 and he was alert and oriented x 4, manual blood pressure 114/60 HR 62 SpO2 97% on room air, patient pink warm and dry. Fire arrived on scene at 147pm and Ambulance shortly after. Fire and Ambulance given report by RN on site while other RN on site continued holding pressure to laceration on forehead with gauze.


VAERS ID: 1134672 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Myalgia, Nausea, Pyrexia, Vomiting
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Shaking chills lasting about 1 hour starting 5 hours after dose Fever to 103 about 6 hours after dose lasting a couple of hours Nausea with intractable vomiting starting 12 hours after dose and lasting 12 hours. Visited immediate care facility and medicated with zofran and fluids. Intermittent mild nausea persisted for about 5 days longer Muscle pain of both lower extremities lasting 6-7 days following vaccine


VAERS ID: 1134697 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-24
   Days after onset: 0
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:
Preexisting Conditions:
Allergies: no known allergies
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient reportedly passed away on 3-24-21 on the day after the vaccine was given. We have no further information at our facility regarding the event.


VAERS ID: 1134754 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Fatigue, Illness, Laboratory test, Mobility decreased, Nasopharyngitis, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: I get sick after the flu vaccine sometimes, but the last time I was fine.
Other Medications:
Current Illness:
Preexisting Conditions: Mild Asthma
Allergies: Penicillin Water pills
Diagnostic Lab Data: CT Scan Blood work
CDC Split Type: vsafe

Write-up: I started feeling nauseous right away, so I had to wait for 30 min. Later that night I started throwing up. I was sick for almost 3 days. I rested a lot because I couldn''t move because I was so tired, achy, really cold and I threw up everything I happened. I waited to contact my doctor in hopes that it would go away, but I couldn''t stop vomiting. By that Monday, I decided to get help. I was told to go to the hospital to get rehydrated. They did a CT Scan and they didn''t find anything. I am waiting to follow up with my doctor since I am still throwing up.


VAERS ID: 1134773 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-16
Onset:2021-03-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Ear infection
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D; Black Cohash; Fiber supplement; Women''s Multi-Vitamin; Evening pills: Melatonin; Valerian Root; Antihistamine - Loratadine
Current Illness: no
Preexisting Conditions: no
Allergies: No
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: Ear (right) was a little uncomfortable - it gradually got worse - by Tuesday afternoon, I went to my fitness class but tapped out half way through and it was around 6 pm that I went to urgent care. Had an ear infection and was given a ten day regimen of amoxicillin. My ear is much better today.


VAERS ID: 1134819 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-04
Onset:2021-03-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide, Cardiac failure, Computerised tomogram abnormal, Condition aggravated, Death, Dyspnoea, Echocardiogram abnormal, Myocardial strain, Pulmonary embolism, Pulse absent, Resuscitation, Troponin increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-17
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypothyroidism Menometrorrhagia Morbid obesity Pulmonary emboli in 2016
Preexisting Conditions: Hypothyroidism Menometrorrhagia Morbid obesity Pulmonary emboli in 2016
Allergies: Shellfish
Diagnostic Lab Data: CT scan on 3/14 showing a pulmonary embolus. Troponin normal, BNP Repeat CT scan on 3/17 showed interval expansion of bilateral pulmonary embolus. Labs demonstrated an elevated troponin, BNP. ECHO showed right heart failure.
CDC Split Type:

Write-up: She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending.


VAERS ID: 1135429 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Full blood count normal, Lip swelling, Metabolic function test normal, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: vitamin D3 keppra multivitamin
Current Illness: none
Preexisting Conditions: dementia, HTN, Sick sinus syndrome with pacer,
Allergies: sulfa antibiotics
Diagnostic Lab Data: normal CBC and BMP
CDC Split Type:

Write-up: tongue and lip swelling concerning for anaphylaxis


VAERS ID: 1135435 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-03-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain lower, Burning sensation, Dizziness, Dyspnoea, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: Felt cramps in my lower abdomen, then in my mid back. Put heat on my back. Then I started to feel very nauseous and light headed, dizzy. Shortly felt a burning feeling in my chest and collar bones, that spread to my head. My head started to burn, it felt like it was on fire, along with my neck and chest. I felt dizzy, like i was going to faint, the burning and dizziness lasted for about 5 minutes. Shortly after i felt like my throat closed up and I was having very labored breaths. The burning feeling in my body and dizziness came back, along with not feeling like i could breathe well. I went to an ER, they gave me an IV with Benadryl, and I started to feel well enough 2 hours later to go home.


VAERS ID: 1135899 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Sexual dysfunction (broad)

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

Write-up: 1432hr Pt fell to the ground c/o shortness of breath & dizziness. Dose of J+J vaccine given about 15 minutes prior. B/P 70/50 HR 84 SPO2 100% on R.A., Lungs clear bilateral. Pt complained of tingling in both hands & feet. Pt refused epi but agreed to Benadryl 50MG po Liquid. Benadryl Administered at 1435hrs no improvement, pt feeling more short of breath & Numbness in Lt arm, 1 dose of epi administered at 1440. Pt had no improvement, pt complained of numbness now in right arm. At 1445 a 2nd epi pen was administered. 1447 pt stated he was feeling better. VS taken BP 100/60 R.24 HR 80 SPO2 97% RA. Lungs Clear bilateral. EMS arrived @1448. Pt stable and was transported to the hospital.


VAERS ID: 1135965 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Reporting employee seated a client for their observation period as they were finishing with her, they turned and saw the client falling from his chair. The client fell on his right side, hitting his right forehead on the floor. The rapid r
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Reporting employee seated a client for their observation period as they were finishing with her, they turned and saw the client falling from his chair. The client fell on his right side, hitting his right forehead on the floor. The rapid response was initiated at 1748, client was alert & oriented x4 to self, time, and location. Vital signs initiated q5 min all within normal limits. EMS called at 1806. Vital signs performed by Tenzin. Ice packs, water, and food provided to alleviate client symptoms. Client expressed "I''m fine" towards the end of the scenario after the 2nd set of vitals which were taken at 1753.


VAERS ID: 1136116 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Dysphagia, Oral pruritus, Paraesthesia oral, Pharyngeal paraesthesia, Throat irritation
SMQs:, 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)

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. none that we were aware of
Preexisting Conditions: unknown
Allergies: prednisone
Diagnostic Lab Data: Has a history of a severe reaction to prednisone. upon inquiring, patient stated it caused insomnia for about a year and was unable to work. No history of any sort of anaphylactic reaction.
CDC Split Type:

Write-up: Within a minute of receiving the vaccine, pt reported itchy/tingly sensation in her mouth and throat. Initially stated she could breathe/swallow just fine but very quickly stated the swallowing was getting more difficult. 911 was called followed by 0.3 mg EpiPen in her right outer thigh and 50mg of oral Benadryl. Her BP was then taken around 4:45 and it was 162/93 at which point EMT arrived and took over.


VAERS ID: 1136174 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenia, Cold sweat, Dyspnoea, Hyperhidrosis, Loss of consciousness, Nausea, Palpitations, Pulse abnormal, Restlessness, Seizure like phenomena, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Akathisia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), 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: Atorvastatin Losartan Metformin Glimepiride Sitagliptin
Current Illness: None noted.
Preexisting Conditions: Hypertension Hyperlipidemia Diabetes Mellitus
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Prior to vaccination, the patient stated that she was nervous, but seemed relieved and okay directly following the vaccination. Following vaccination, patient became restless during the 15 minute post-vaccination window about 2-5 minutes after receiving the vaccine. She initially presented with uncontrollable shaking/bouncing legs, palpitation, sweating, and shortness of breath (though this was very brief. Patient remained coherent and oriented to time/person/place. The shaking and palpitations subsided after a couple minutes and resumed towards the end of the 15 minute waiting period, accompanied by nausea. 25 minutes post-vaccination she appeared to have stabilized, and we assisted the patient to her room nearby at her request to allow her to lie down while being monitored. After returning to her room, she very quickly ran to her sink due to her nausea, then after a minute of attempting to vomit, she collapsed and appeared to have briefly lost consciousness. EMS was called and the patient was rolled onto her side to prevent choking in the event of emesis. Patient remained responsive, but was weak and clammy with a weak pulse and breathing. After the firefighters came, a search of the apartment found the previously listed medications. Additionally, the patient experienced a seizure-like episode lasting 15 seconds in duration. Once the EMT came, they assessed her and monitored her in the ambulance; they reported that her condition appeared stable, her vitals were strong, and transported her to Hospital for observation/testing.


VAERS ID: 1136183 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aggression, Blood culture, Blood lactic acid, Body temperature increased, Bone scan, Chest X-ray, Chills, Computerised tomogram, Confusional state, Culture urine, Fall, Full blood count, Lethargy, Metabolic function test, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Buprenorphine patch all the time Pepcid -am Gabapentin-am Robaxin- am Hydrocortisone-am Levothryoid am Aspirin ec am Vitamin D3 am Chromium picolate am Vitamin c Dhea Vitamin e Omega 3 Magnesium Comprehensive immune support Astragalus
Current Illness:
Preexisting Conditions: ,High blood pressure, fibromyalgia, mixed connective-tissue disorder in OS, inflammatory arthritis, adrenal insufficiency, sarcoidosis, Sjogren?s, heart disease
Allergies: Penicillin, Keflrx , Iodine, , Diovan Van
Diagnostic Lab Data: A full workup was done blood cultures CBCCMP Lactic acid Urinary culture there was a CT scan and bone scan done because of the fall chest x-ray also done. All done on March 25, 2021
CDC Split Type:

Write-up: At around 3:30 am patient or my mum sorry having chills shivering muscle aches her temperature was 102.5 took Tylenol and fell asleep around noon that day very confused swore she took Tylenol but didn?t bell and couldn?t get off the floor again very confused lethargic MS was called temperature noted to be 106 Greece Fahrenheit was taken to the hospital given three bags of fluids was given Tylenol even though patient was argumentative and said she took Tylenol continue to be confused and lethargic throughout the stay at the hospital upon leaving hospital at 8 pm temperature was 100.7 patient was able to walk


VAERS ID: 1136209 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-12
Onset:2021-03-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Electrocardiogram, Flushing, Heart rate irregular, Immediate post-injection reaction, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Pepcid, Fish oil, probiotics, multivitamin, calcium and magnesium, vitamin D
Current Illness: None
Preexisting Conditions: Allergies, GERD
Allergies: I have a wheat allergy, I have environmental allergies, I have skin allergic reactions to chemicals
Diagnostic Lab Data: I went to the emergency room, and they did an EKG and the results were normal. They did the EKG after about three hours post Vaccine and I was already starting to feel normal by then. My symptoms lasted two hours and then they started to go away.
CDC Split Type:

Write-up: Within five minutes, I experienced extreme lightheadedness, and over the course of two hours my symptoms worsened and included irregular heartbeats with some of them feeling like stronger beats, Diarrhea, nausea, feeling like I was going to throw up, Flushing heat on my chest, chills


VAERS ID: 1416834 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Nausea, Palpitations, Paraesthesia, Presyncope, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Dizziness, NauseaVomiting, Palpitations, near syncope/tingling in extremities Narrative: Employee presented to the ER for evaluation within 15 minutes of vaccine with dizziness, palpitations and feeling nauseated. She reported tingling in her legs as well. She was monitored-required IVF, pepcid and benadryl in the ER. Other Relevant History:


VAERS ID: 1417018 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Myalgia, Nausea, Photophobia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: chills Narrative: Patient is a 56-year-old male with history of paranoid schizophrenia, COPD/ emphysema, alcoholic hepatitis and alcohol use remission who presents for ED evaluation of 1 day of pressure-like frontal headache with light sensitivity, myalgias, chills and fatigue, the symptoms are following the first Covid vaccine yesterday. Patient has not tried anything for the headache at this time, describes that is not different from his previous headaches. Does report some nausea without vomiting.


VAERS ID: 1417026 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia oral, Lip pruritus
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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: itching/numb lips Narrative:


VAERS ID: 1417129 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Narrative: Pt. reported to the local ER where he was treated for rapid heartbeat.


VAERS ID: 1136498 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-17
Onset:2021-03-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Shoulder injury related to vaccine administration
SMQs:, Arthritis (broad)

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

Write-up: Patient says she has chronic shoulder pain which started about 3 days after vaccination. Pt states she is 108 lbs and we suspect SIRVA resulting from using a needle too long for injection


VAERS ID: 1136614 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN; 1802070 / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: N/A
Allergies: No known allergies
Diagnostic Lab Data: ER visit for persistent diffuse itching without rash 3/23/21 - treated with benadryl and hydroxyzine --- $g no benefit with treatment reported 2nd ER visit 3/25/21 for persistent diffuse itching without rash - treated with oral prednisone 40mg daily x 5 days.
CDC Split Type:

Write-up: Diffuse body itching without visible rash


VAERS ID: 1136826 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: Patient started experiencing rapid heart rate around 4AM on 3/26/2021, she had reported to the pharmacist she also has had some dizziness and has stayed in bed. She did have some of the other usual side effects of the vaccine - chills, mild headache, tired. The rapid heart rate has not subsided or worsened. She doesn''t have a primary care doctor. The pharmacist recommended she call 911, which is recommended, just in case it is an allergic reaction and it can be treated quickly.


VAERS ID: 1136915 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Complaint of itching and tingling around neck, ears, and face. Felt as if had rapid heart rate and short of breath. Blood Pressure stable at 150/85 and 158/90 and Heartrate 66-80/min. O2 Sat 88% when EMS arrived. Epinephrine .5mg epinephrine administered and Benadryl 50 mg IM; O2 at 2 L NC. EMS called and transported to Medical Center. Stable at time of departure with EMS at 9:34. Reaction started within 15 minutes of receiving vaccine.


VAERS ID: 1136922 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Blood sodium decreased, Blood test abnormal, Chills, Diarrhoea, Pain, Pyrexia, White blood cell count decreased
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On Sunday March 21, 2021, while in the emergency room, they took blood from which resulted in them saying my sodium was a little low and my white blood cells count was also low.
CDC Split Type:

Write-up: I received the Johnson and Johnson vaccine on Saturday March 20, 2021. Later that evening, I started to experience diarrhea which followed by severe stomach pains. After that, a fever came then chills and body aches. My temperature was 100.08. The following day, I woke up and checked my temperature and it was 101.09. I went to the emergency room. They gave me fluids in an IV and something the pain as well as Tylenol. I was discharged and told to rest until Monday. I returned to on Tuesday.


VAERS ID: 1136946 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diplopia, Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Ocular motility disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: numbness to left side, headache and double vision


VAERS ID: 1136997 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-03-13
Onset:2021-03-22
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Central nervous system lesion, Magnetic resonance imaging head abnormal, Magnetic resonance imaging spinal abnormal, Myelitis transverse, Spinal cord injury cervical
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium, probiotic
Current Illness: na
Preexisting Conditions: na
Allergies: erythromycin, pencillin
Diagnostic Lab Data: MRI brain and C spine 3/24/21 Brain and upper cervical spinal cord lesions likely secondary to acute transverse myelitis (with brainstem involvement). Neuromyelitis optic spectrum disorder another potential cause MRI L and T spine 3/23/21 Extensive lesion of upper thoracic spinal cord compatible with acute transverse myelitis LP 3/24/21 Protein 81 WBC 180 RBC 167 NMO-antibody pending
CDC Split Type:

Write-up: Transverse myelitis


VAERS ID: 1137261 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Pain, Pyrexia, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Recipient call the employee health office approximately 24 hours after receiving vaccine stating that they had gone in to an emergency department for evaluation of symptoms. symptoms reported include fever, headache, chills, body aches and blurred vision. Recipient reports that ED physician evaluated her and sent her home with instructions to return in 72 hours if symptoms persist or sooner if symptoms worsen.


VAERS ID: 1137432 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-15
Onset:2021-03-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthritis, Condition aggravated, Gait inability, Pain, Walking aid user, X-ray abnormal
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin, Gabapentin, Carvedilol, probiotic, magnesium, apple cider vinegar, biotin, red yeast rice, vitamin E, cranberry, multi-gummies, calcium.
Current Illness: None.
Preexisting Conditions: Osteoarthritis, high blood pressure, osteoporosis.
Allergies: Morphine.
Diagnostic Lab Data: X-ray that showed arthritis.
CDC Split Type:

Write-up: She received the vaccine, no problems initially, no real arm soreness. The next morning when she woke up she could not walk, had to hold onto something to walk, and has a lot of pain, and has not improved even with taking pain medications. There has been no improvement from the pain. There are times that she feels just a little better, but then returns back to where it was. She went to the ER on 3/17/21, they said that she had arthritis which she had but she has not had this type of pain until the vaccination. They gave her some pain medicine which did not help at all. She again is taking some pain medication now but the pain is still there. She can stand on her leg and it doesn''t hurt, but when she moves her leg is when it hurts. She is now using a walker which she did not have to use before the vaccine.


VAERS ID: 1137535 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-09
Onset:2021-03-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Headache, Pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra24 Hrs OTC taken on Sat 03/13)
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Covid test done at urgent care
CDC Split Type: vsafe

Write-up: So after I got the shot I had a sore arm for 4 days and when I mean sore I mean pretty sore, if I lifted something it would hurt. It was more sore than the normal for a shot. On Sunday the 14th I woke up with a fever (103F) shortness of breath and a headache, on Mondya the fever was a little lower in the 100s and I still have the shortness of breath. The next day I only had the fever and the whole week I just had a low grade fever (in the 99s) and on Saturday I woke up with high fever again and decided to go get a covid test. My fever broke when I was at the covid test site (Urgent Care) but at night it was back again. My test was negative. I noticed that every time I had high fever, 100s I had shortness of breath - the fever lasted 14 days (low grade for most part). Monday 03/29/2021 at 1:15 I have an appt with my PCP.


VAERS ID: 1137564 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-19
Onset:2021-03-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chills, Electrocardiogram abnormal, Headache, Loss of personal independence in daily activities, Palpitations, Pyrexia, Sinus tachycardia, Sleep disorder, Tachycardia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone 50 mg/night Retin-A - 3x/week
Current Illness:
Preexisting Conditions: asthma kidney stones
Allergies: None known
Diagnostic Lab Data: EKG: sinus tachycardia - 3/20/21 at 1:00am
CDC Split Type:

Write-up: 4 hours post-vaccine, started to shiver 6 hours post-vaccine spiked fever of 102.2 7 hours post-vaccine developed headache and began to vomit 8 hours post-vaccine, I went to the ER They found I had tachycardia for the duration of my visit (11pm - 3 am). Administered Toradol and IV fluids, discharged me with good vitals, but still tachycardia, headache, and vomiting. The next day (3/20), I still had a bad headache and could not keep liquids down. I vomited perhaps 12 times, then called the doctor. She sent me to Urgent Care to receive injections of Toradol and Phenergan. Within the hour, I could drink. Then shortly after, I could eat. I felt better for one day. The next day (3/22), my heart started pounding, and I was unable to sleep horizontally. I needed to sleep on 3 pillows due to chest discomfort. My chest still feels very uncomfortable. Abdominal breathing is helping to an extent. I have had to stay in bed and greatly reduce my activities since receiving the vaccine. Today is one week, and I am still in bed.


VAERS ID: 1137573 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cyanosis, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: After receiving the vaccine, patient became diaphoretic, lips were turning blue and patient seemed very weak. Vital signs were taken and oxygen administered. Patient was transferred to a stretcher and taken to the ED for observation. He was given some juice and crackers and went home. Patient''s mom was present throughout all of the event and desired to take the patient home.


VAERS ID: 1137694 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-16
Onset:2021-03-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan Singular Advar Cimacort
Current Illness: Slight cough
Preexisting Conditions: COPD Asthma
Allergies: Novocain Penicillin
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I just started having problems breathing, I couldn''t catch my breathe and heart rate went sky high. I ended up going to the ER, they have me some steroids and breathing treatments, monitored my heart rate for three hours. I stayed in the ER for 4 hours and discharged me. The next day I was feeling a little week but breathing better and heart rate was back down to normal. I have a cough that''s lingering a dry cough.


VAERS ID: 1137715 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-12
Onset:2021-03-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Heart rate increased, Lip swelling, Rash, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Birth defects: omphalocele repaired, scoliosis, ventilator dependent until age 2, and oxyben dependent until 2 years, 6 months. Intolerance to high altitudes over 6,000 feet, needs oxygen when exercising as of June 2020..
Allergies: None
Diagnostic Lab Data: Please contact Hospital for medical tests and laboratory results. As Patient''s mother I only have the information that all tests were normal.
CDC Split Type:

Write-up: Seven days after vaccine was administered Patient started having symptoms of difficulty breathing, rapid heart rate, and breaking out in a rash all over his torso and upper arms. His lips also got quite swollen. The rash eventually spread down both his legs. He was taken to the emergency room at Hospital, as he was visiting there at the time. He was given benadryl, and prednisone once his Covid test came back negative. Blood work, chest x-ray, CT scan of both stomach and chest, EKG and blood work all came back normal. His resting heart rate was 120 and above, and he required two liters of oxygen to stay in the mid 90''s saturation level. He spent five days in the hospital before the rash was mostly faded on his torso and his lip swelling had come down. He was discharged on 3/24/21 with the advice to see his primary care physician, and to be monitored carefully for oxygen saturation and heart rate. The family could not think of anything he had eaten or come in contact with that would have caused any reaction. At this time we think it was a reaction to his Janssen vaccine based on all the tests at the hospital coming back normal.


VAERS ID: 1137771 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Dehydration, Glassy eyes, Malaise, Pallor, Unresponsive to stimuli
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (narrow)

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

Write-up: Less than 10 minutes after injection, patient verbalized she did not feel well, then became unresponsive to verbal cues, eyes glazed over, pale face. Clinic was being held outdoors, clinic staff could not get accurate vital signs. Call EMS. Meanwhile, patient began to respond to verbal cues, was able to walk inside, said her stomach hurt. EMS arrived and also had difficulty obtaining vital signs, transported to the local ER. Patient was treated and released from the ER with a diagnosis of dehydration.


VAERS ID: 1137919 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-03-20
Onset:2021-03-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / N/A LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Blood test normal, Dizziness, Magnetic resonance imaging normal, Sleep disorder, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins, vitamin D3
Current Illness: None
Preexisting Conditions: Chronic acid reflux
Allergies: None
Diagnostic Lab Data: Blood tests and MRI done at ER on 3/25. Everything came back normal, though still waiting on results from tick panel.
CDC Split Type:

Write-up: Started having blurry vision/trouble focusing eyes/feeling dizzy on Monday. By Wednesday, this was very difficult to handle and I went to see a practicioner at my primary care office and I could not sleep at all on Wednesday night; went to the ER on Thursday morning out of major concern.


VAERS ID: 1137935 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Pain, Pregnancy test negative, Rash, Rash pruritic, Skin burning sensation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: diphenhydrAMINE (BENADRYL) 25 mg tablet famotidine (PEPCID) 20 mg tablet fexofenadine (ALLEGRA) 180 mg tablet methylPREDNISolone (MEDROL DOSEPACK) 4 mg tablet
Current Illness: N/A
Preexisting Conditions: Obstructive Lung Disease
Allergies: Diflucan [Fluconazole]Hives Terazol 7 [Terconazole]Hives PrednisoneSwelling
Diagnostic Lab Data: 1519 Patient is feeling much better no more burning or itching to the body. Lesions had decreased and is minimal will discharge patient on Medrol pack, drill Pepcid. Patient is cleared for discharge home. 1520 Patient received IV Decadron and did not have any reaction to the Decadron. Patient also told me that when she received the prednisone in the past her face CT little bit swollen but when they decrease the prednisone dosage, swelling subsided. Discharge patient on Medrol pack Benadryl and Pepcid. POCT pregnancy test done, which was negative.
CDC Split Type:

Write-up: Patient went to ED on 3/21/2021, due to reaction from vaccine. C/o chills, headache, generalized rash, body aches and hives. At hospital when examined by physician patient observed with anterior chest and back with urticarial rash that is pleuritic, rash also evident in the left arm bilateral hands and soles of feet all of which are pruritic .


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