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

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



Case Details (Reverse Sorted by Onset Date)

This is page 51 out of 1,889

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VAERS ID: 1206993 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Systemic: Tinnitus-Mild, Additional Details: sounds like butterfly in ear


VAERS ID: 1207005 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu vaccine, age 30, throat tightness
Other Medications: Tramadol Welbutrin Lamictal Labetalol
Current Illness: none
Preexisting Conditions: fibromyalgia chiari malformation
Allergies: latex shellfish contrast dye nausea medications bromicriptine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylaxis approximately 18 min after vaccine injection. Received epinephrin through epi pen. Transported to hospital via ambulance. Received IV steroids at hospital and monitored for 4 hours.


VAERS ID: 1207100 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

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

Write-up: Symptoms: On Monday April 12 while at work, I felt dizi, like fainting and when walking I felt like I was not walking straight. It was intermittent, sometimes I was feeling fine, and later on, I started feeling as described (dizi, feel like things around me were moving). It was very strange. When to see the nurse at work and my blood pressure was 122/87. On April 13, went so see my doctor, I was feeling fine, but my blood pressure was 120/90. It is kind of high for me, as I have a history of low blood pressure . Janssen COVID-19 Vaccine EUA


VAERS ID: 1207104 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Dizziness, Fatigue, Headache, Myalgia, Pain, Pyrexia, Swelling, Swelling face
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: rash on lower legs after MMR, 18 yrs of age
Other Medications: Diphenhydramine 25mg and Acetaminophen 1000mg at 8pm the night before vaccine.
Current Illness: allergies due to pollen, Iron deficiency anemia
Preexisting Conditions: intermittent iron deficiency anemia, and year round allergies due to dust, pollen, & mold.
Allergies: Ampicillin, peanuts, milk, Monosodium Glutamate.
Diagnostic Lab Data: None so far
CDC Split Type:

Write-up: Fatigue and Swelling in face which spread to entire body and I took 5mg loratadine initially because I was at work. Headache which was intermittent throughout vaccine day and 4/12/2021 thru 4/14/2021. I took 800mg ibuprofen and 25mg diphenhydramine at 8pm 4/12/2021. Fever presented at 6:30pm on 4/12/2021. At 6:45p,m chills and shivering. I turned heater to 81 degrees . At 9;58pm my fever was 100.8 degrees F. I took 1075mg Aspirin at some point during the evening of 4/12/2021. During the day of 4/12/2021 I had joint pain and pain that progressed throughout my body. I had intense back pain from below my shoulder blades to below my waist during the day of 4/12/2021 and got progressively worse as the day progressed. Swelling slowly getting better still a little swelling on 4/14/2021. Muscle aches, Pain, still remain on 4/14/2021 but are less. Fatigue is still intense on 4/14/2021. Diphenhydramine 25mg and Aspirin 1075mg have been taken intermittently from 4/12/2021 to 4/14/2021. One dose of Meclizine 12.5mg because of dizziness on 4/13/2021.


VAERS ID: 1207112 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN COVID-1 / 1 RA / IM

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

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

Write-up: Arm numbness/tingling. Starts at wrist, works up full length of arm in course of 15-30 minutes. Lasted an hour straight, then subsided, had started again .


VAERS ID: 1207260 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Tinnitus
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hearing impairment (narrow)

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

Write-up: Apart from the expected side effects (headache and chills, some soreness at injection site), I believe I''m experiencing tinnitus or a similar ringing in my ears. It appears to be concentrated in my left ear, although it''s hard to tell. There''s a consistent high-pitched tone that won''t go away. I''m not entirely sure when it started (maybe 24-36 hours after receiving the vaccine), but it''s gotten slightly worse since then and is more noticeable. I have not been able to go to the doctor yet.


VAERS ID: 1207331 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: smoking (5 yrs), TB positive
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 hours after injection: chills, body ache, mild headache, loss of appetite, injection site soreness 11 hours after injection: chills, severe body ache, severe headache, fever of 101.2F, loss of appetite , injection site soreness 13 hours after injection: 350mg of Ibuprofen taken day following vaccine: slight headache, fatigue, injection site soreness, additional 350mg of Ibuprofen 2nd day following vaccine: only injection site soreness


VAERS ID: 1207467 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Feeling cold, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Post vaccination patient reports soreness of Left arm, light headedness, nausea, and feeling cold. Sent for observation 5:15pm vitals: Pulse 90 BP 131/81 RESP 16. At 5:34pm Pulse 81 BP 118/89 RESP 16. Patient improved with no other symptoms., and released from facility.


VAERS ID: 1207474 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Limb discomfort, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit c Vit D Zinc
Current Illness: One week ago developed Stye Tx with Doxycycline twice a day for 7 days and ophthalmic drops with neomycin and polymyxin Two weeks ago developed URTI Tx with Z-Pack
Preexisting Conditions: Bronchial Asthma
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 3 1/2 hrs developed fatigue, hip and low back pain, and bilateral legs discomfort Pain scale 6/10 Using Advil


VAERS ID: 1207495 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: 101 fever, body aches, chills,


VAERS ID: 1207496 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Gait disturbance, Headache, Hypoaesthesia, Muscular weakness, Oropharyngeal pain, Pain in extremity, Painful respiration, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament 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: Lisinopril 80 mg QD
Current Illness: HTN Atrial Fib
Preexisting Conditions: History of enclosed head injury from MVA years ago. Still sees neuro for " shots to my neck and sometimes to drain fluid"
Allergies: NkDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Husband called this am ( 04/14/2021) to ask questions about pt" side effects of vaccine" Called and spoke to pt. .Pt reports receiving J&J vaccine on 04/12/2021 at 12:30 pm. She began noticing " a severe headache" about 5:30 pm. She relays between 8:00 and 10:00 pm she begin experiencing " leg weakness that made it hard to walk" " I was suddenly walking like a 95 year old woman". This continued and on 04/13/2021 she reports that she noted " the tops of both feet became numb and my left foot was swollen" Relays legs now hurt to front and back of thighs and also at times behind knees. This am ( 04/14/2021) she reports " when I take a deep breath a pain shoots from my throat to underneath my right armpit. Advised pt to go to ED now and notify them of recent vaccine.


VAERS ID: 1207578 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac monitoring, Dizziness, Electrocardiogram, Fall, Headache, Immediate post-injection reaction, Nausea, Pain in extremity, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: allergic to sulpha drugs
Diagnostic Lab Data: Blood work, EKG and heart monitoring
CDC Split Type:

Write-up: I immediately got a headache after the shot and became dizzy several hours later. I went to bed around 9 pm and then woke up around 10 am and was very dizzy and my arm was in severe pain. I had to vomit so I got out of bed and fainted and fell to the floor. I got up again and then fainted and hit the floor. My husband then called 911 and I was transported to the hospital.


VAERS ID: 1207608 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Groin pain, Nucleic acid test, Screaming, Swelling, Testicular pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Lorabid
Diagnostic Lab Data: GC and Chlamydia by Nucleic Acid amplification. US Pelvis Scrotum/Doppler
CDC Split Type:

Write-up: Prior to receiving vaccine patient was normal healthy 24 year-old male, with no underlying health conditions. Pain and Swelling in Groin area/Testicular Pain (on 4/12/2021). Started as discomfort at 9:00 a.m. and gradually worsened during the day. By midnight pain was sever, no position would give relief. Pain intensified to causing loud painful screams. Took 600 mg of Ibuprofen waited 20 minutes with no relief. Taken to local hospital ER, Emergency Department, Upon release from ER- recommended to see Urology Specialist. As of 4/14/2021 patient is still taking Ibuprofen for discomfort. Pain has lessened and is not as intense but is still present.


VAERS ID: 1207640 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20JA21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cyst, Migraine
SMQs:

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

Write-up: Not so much adverse than great. I had a migraine that morning and knew not to take my medication before the shot. I muddled through the day and was going to take prescription meds that evening. Within 10-15 mins after receiving my shot, my migraine went away. I don''t get them often, but it has never gone away on its own. I also noticed a small pea size cyst on my forearm has diminished greatly in size since my vaccine. I don''t know if all this is coincidence, just thought I would report it.


VAERS ID: 1207699 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-03-25
Onset:2021-04-12
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: JOHNSON AND JOHNSON VACCINE


VAERS ID: 1207717 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Headache, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient is on medications but Mom could not give us list of medications at the time of reporting
Current Illness: Unknown
Preexisting Conditions: Depression
Allergies: NKDA
Diagnostic Lab Data: Patient is scheduled to see her Mothers'' doctor today at 1 p.m
CDC Split Type:

Write-up: Patient''s mother called on 4/14/21 to report that her daughter have been having severe headaches, severe abdominal and leg pain since getting vaccine on Monday night


VAERS ID: 1207727 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-04-12
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Facial pain, Headache, Nausea, Neck pain, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Arthritis (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:
CDC Split Type: 02037655

Write-up: Severe headache on right side of the head, pain irradiates to neck and right side of the face, nauseous


VAERS ID: 1207743 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Cold sweat, Dyspnoea, Dysstasia, Head discomfort, Headache, Hot flush, Nausea, Pain, Pyrexia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 4:30- chills, headache 5:00- chills worsened, headache, pressure in my head when I moved 6:00- hurt to breath when laying down 6:30- 101 degree fever 7:30- pain in my head worsened when I moved 8:00- bed *woke up every 10 min* *next day* 6:00- 100 degree fever, still hurt to stand, nauseous, really really weak, chills 7:00- chills and hot flashes (with same symptoms as before) 12:00- started to feel a little better- still cold and headache 8pm- feeling okay *next day* Clammy but good


VAERS ID: 1207755 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Cardiac arrest, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

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

Write-up: Patient received J and J covid vaccine on 4/11/21 at an unknown location. Patient presented to hospital in cardiac arrest on 4/12/21. Patient was resuscitated and it was noted the patient had a ST elevation myocardial infarction. Due to the patient''s size (246.7kg) she was unable to be treated for her condition with our equipment as she was over the weight limit for our equipment. She was transferred for additional care


VAERS ID: 1207854 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Erythema, Feeling cold, Feeling hot, Hot flush, Pain, Swelling face, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: My blood pressure was 150 over 85 and no temp. My throat was not sore and no numness.
CDC Split Type:

Write-up: Started on Monday morning at 8:30 am started feeling cold chills. Took 800mg of Ibuprofen and after an hour felt better. When going to bed around 9:00pm I noticed that my skin was soaking wet and that I had a hot feeling. When I woke up in the morning (tuesday April 13, 2021) around 7am I could not fully open my eyes. I looked in the mirror and noticed that my entire face was swollen and was red in different areas. I took some benadryl as I thought this was an allergic reaction and went back to bed. A litter later I started getting cold chills and then hot flashes. Around noon time I took another benadryl. By 2:30 I was not feeling any better and I also had body aches and pains and called my doctor. I was able to get in to the office. I was told that I was having a reaction to the shot and that I was boarder line for the hospital. They gave me a shot steriod shot and prescribed Metheylprednisolon tablets (24) to be taken as directed and to continue to take benadryl. It''s now Wednesday morning April 14, 2020 and the swelling has gone down but not fully gone and I have stated on the prescription. I now have redness in my chest area. I still have a some chills and hot flashes.


VAERS ID: 1207918 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Mobility decreased, Musculoskeletal stiffness, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu like symtoms after a flu vaccine
Other Medications: 40mg Latuda, 3mg Melatonine, 500mg Pentasa
Current Illness: none
Preexisting Conditions: crohn''s disease
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Significant leg pain in the thighs of both legs. Including stiffness and hard to move them. This lasted for 2 days at the same pain level. On the third day the stiffness, pain, hard to move went down to about 5% of what it was.


VAERS ID: 1207922 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042421A / N/A RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 88 mcg
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, Aches, Chills, Fatigue have been ongoing since approximately 8 hours after the I had the vaccine. I had the corona virus in July 2020 and I feel like I did when I had the virus only worse! I am now going on day 3 and am still feeling these adverse affects and am wondering how long I can expect them to last. When I had the virus in July 2020, I was sick for 3 weeks. Will I be sick for 3 weeks with these vaccine side affects? I am taking tylenol and ibuprofen but they are not helping much. Taking Vitamin D and Zinc supplements and trying to drink lots of water. I haven''t yet contacted my doctor thinking these side affects will go away soon but I am getting concerned.


VAERS ID: 1207924 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: few minutes after patient got vaccine, he fainted, he was pale, dizzy. we laid him down on the floor and after 1-2 minutes he open his eyes and start talking. we observed him for 30 more minutes.


VAERS ID: 1207931 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

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

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

Write-up: Client was given a Johnson and Johnson vaccine instead of a second dose of Moderna vaccine, client has had no adverse reactions at this time.


VAERS ID: 1207950 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-22
Onset:2021-04-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Bad muscle cramp on left calf while running on Monday morning - pain has persisted since, although pain has subsided since Monday.


VAERS ID: 1207976 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Patient had a syncopal episode then vomited after she woke up


VAERS ID: 1208000 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvistatin 10mg
Current Illness: Nil
Preexisting Conditions: Nil
Allergies: Nil
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had an appendectomy just over a week after first Pfizer vaccine


VAERS ID: 1208016 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

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

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

Write-up: Two days after injection: dizziness & nausea (vertigo). Persists to current time (2.5 days later).


VAERS ID: 1208018 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N?A
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: NKDA
Diagnostic Lab Data: None needed, no side effects noted
CDC Split Type:

Write-up: We sent out an email to store associates over 18 years of old to have prefilled out VAR for an offsite clinic. Pt showed up to get vaccine, consent form signed, was screened down the list and the vaccine was administered. Staff returned to bill the vaccine on 4/9/21 and our system on halted it due to pt age. I was made aware of the error on 4/12/21 when I returned from the weekend. We then looked deeper into the VAR to find it had been signed by the father for consent to give the vaccine to his daughter.


VAERS ID: 1208084 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Janssen COVID-19 vaccine EUA 4pm- fatigue 7pm-2am- fever, chills, bodyache, headache, soreness on left arm


VAERS ID: 1208099 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Feeling abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: I have not felt it again since Monday Morning.
CDC Split Type:

Write-up: I was give the vaccine 7pm at night and woke up the following morning and started to feel tingling from my elbows to finger tips. It felt odd but no other symptoms. I was at the grocery store and while reading the label of a mustard jar I inadvertently dropped it which was also odd. This was 2 days ago and at the time it seemed like a harmless mild side effect but now that I see incidence I''m reporting it.


VAERS ID: 1208111 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cough, Headache, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Valacyclovir
Current Illness: Sprained ankle/foot, Pink Eye
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: I have not gone to the doctor.
CDC Split Type:

Write-up: Headache on 4.11, 4.12-took ibuprofen prescribed for ankle injury and it went away Left leg pain on 4.11, 4.12 but went away. Dry cough since 4.11.21


VAERS ID: 1208127 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dysstasia, Emotional distress, Feeling abnormal, Pain, Pyrexia, Restlessness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data: I didnt end up going to the ER,I finally was able to fall asleep. I still dont feel back to normal but I feel like the next day or two I will.
CDC Split Type:

Write-up: I have never had side effects to a vaccination before so it was completely unexpected but it had been approximately 9 to 10 hours (which I had a hard time entering on the page prior where it asked me the times.i couldn''t get it to okay how I had the time) but I had felt completely fine and normal directly after and that evening, but close to around 9 or 10 hours later I developed such a high fever so fast when I took it, it was 103.7 and i could barely stand up to get the thermometer i was SO weak and my whole body ached so bad. I couldn''t stop crying I was so miserable and had to have my ex boyfriend come take care of me because I didnt have anyone else to, but it got so bad I was strongly considering going to the emergency room...I tried to sleep but my body was so restless. I took ibuprofen and it broke my fever but today I still feel achey and weak. I definitely wasn''t expecting that because the guy that did mine said it''s rare and if they do happen they are mild...I would consider my symptoms higher than mild. There was nothing else that could caused it..everything was the same and the only different factor was the vaccine so I''m 100% sure that it was the cause.


VAERS ID: 1208140 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Injection site pain, Injection site swelling, Injection site warmth, Rash papular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: big round swelling and tenderness below where shot was. warm to touch, slightly raised. happened 2 days after vaccine was given.


VAERS ID: 1208149 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Electrocardiogram, Fall, Head injury, Heart rate decreased, Hyperhidrosis, Loss of consciousness, Presyncope
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG, CT of head done on 4/12/2021. He was monitored to make sure his heart rate went back up and was released a few hours later.
CDC Split Type:

Write-up: 5 minutes after receiving the injection, my husband passed out, starting sweating profusely, and was out cold for a minute. EMS were called and he was seen in ER due to low heart rate and sweating to rule out any heart conditions. He had 2 EKGs - one in the ambulance and one in the ER. He also had to have a CT for falling and bumping his head to rule out that injury. The DX was listed as a vagal response, but we are not so sure we agree given that he is 45 years old, has no priory history or anxiety about shots.


VAERS ID: 1208150 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Feeling cold, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol 500mg
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Fever and chills 12 hours afterward Severe Headache since injection Fever up to 101 since injection, Tylenol and IBprofin to keep fever reduced


VAERS ID: 1208185 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Chills, Dizziness, Electrocardiogram normal, Full blood count normal, Hypotension, Pain, Pyrexia, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Digestive Enzyme, Reflux Release, Herbal Tea
Current Illness: no
Preexisting Conditions: no
Allergies: dairy, soy, onions, garlic, oil stone fruits, All Penicillins, Mycin-drugs
Diagnostic Lab Data: Chest X-ray-normal EKG-normal CBC-normal
CDC Split Type: vsafe

Write-up: During the night I felt like I had a fever, chills and body aches. And the next morning after I woke up needing to use the restroom, got up but started feeling dizzy and fainted for about 2minutes. EMT was called and once they arrived I began vomiting and my BP was super low. During the transport to the hospital I vomited again and was given antinausea meds. At the ER I was given IV fluids, chest xray, EKG and blood was drawn and I was released after a few hours of monitoring


VAERS ID: 1208205 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-27
Onset:2021-04-12
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Deep vein thrombosis, Erythema, Pain in extremity, Skin warm, Swelling, Thrombophlebitis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil, losartan potassium
Current Illness:
Preexisting Conditions: High blood pressure. herpes simplex
Allergies: hazelnut, penicillins, amoxicillin, sulfamethoxazole, Vitamin - B
Diagnostic Lab Data: urgent care medical examination (April 14, 2021) waiting primary cared physician exam on April 15, 2021
CDC Split Type:

Write-up: deep vein thrombosis, swelling, pain in both legs and lower abdomen. warm and red skin. red swollen veins.


VAERS ID: 1208214 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Disturbance in attention, Fatigue, Memory impairment, Pain, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loss of focus/concentration Forgetfulness Unable to multi-task Sleeping more than usual Fatigued by middle of the day I never had any of the above issues before getting vaccine, I had chills, fever, body ache on the night of the 8th April after getting vaccine shot and was recovered well by 10th April


VAERS ID: 1208222 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-22
Onset:2021-04-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Diverticular perforation, Intensive care, Mechanical ventilation, Surgery, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal perforation (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, B complex, Donepezil, escltalopram, Fish oil, Flonsae, duoneb, maalox, melatonin, metoprolol, plavix, resveratrol, rosuvastatin, multivit w/ minerals, flowmax, tylenol.
Current Illness:
Preexisting Conditions: BENIGN NEOPLASM OF COLON, ACUTE CYSTITIS WITHOUT HEMATURIA, UNSPECIFIED DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE, PERSONAL HISTORY OF TRAUMATIC BRAIN INJURY, IDIOPATHIC ASEPTIC NECROSIS OF RIGHT FEMUR, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS, BENIGN PROSTATIC HYPERPLASIA WITH LOWER URINARY TRACT SYMPTOMS, PERIPHERAL VASCULAR DISEASE, RETENTION OF URINE, ALCOHOL DEPENDENCE, PRESENCE OF UROGENITAL IMPLANTS, ALLERGIC RHINITIS, UNSPECIFIED, OBESITY, ACUTE PYELONEPHRITIS, ALCOHOLIC POLYNEUROPATHY, SPONDYLOSIS WITHOUT MYELOPATHY OR RADICULOPATHY, CERVICAL REGION, INSOMNIA, MIXED HYPERLIPIDEMIA, DISORDER OF ARTERIES AND ARTERIOLES, ALCOHOLIC HEPATITIS WITHOUT ASCITES, IDIOPATHIC ASEPTIC NECROSIS OF LEFT FEMUR, PREDIABETES, ELEVATED PROSTATE SPECIFIC ANTIGEN [PSA]
Allergies: Simvastatin, Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per res. being taken to surgery for a perforated diverticulum. ICU, resident had made it through surgery, resident is off the vent, not really responsive at this time and will be keeping a close eye on him.


VAERS ID: 1208226 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Saphris, Zyprexa, gabapentin, clonazepam, propanolol, topamax, trazodone, cogentin, (possibly also ativan and adderall - on record, not reported by patient to me- emergency physician).
Current Illness: none reported.
Preexisting Conditions: schizophrenia, agoraphobia, anxiety, panic attacks
Allergies: NKDA
Diagnostic Lab Data: ultrasound 4/13/2021
CDC Split Type:

Write-up: DVT left leg


VAERS ID: 1208233 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chills, Dizziness, Dyspnoea, Headache, Hyperhidrosis, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: N/A
Current Illness: UTI
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Oxygen levels, blood pressure, and everything normal
CDC Split Type:

Write-up: Cold chills, sweat, nausea, vomiting, horrible headaches, dizziness, and lightheaded, burning sensation around abdominal area, difficulty breathing.


VAERS ID: 1208265 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Hypoaesthesia, Laboratory test, Paraesthesia, Skin warm
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? No
Hospitalized? No
Previous Vaccinations: pneumonia shot: high fever
Other Medications: birth controls, Zyrtec, multivitamin
Current Illness: nothing
Preexisting Conditions: RA
Allergies: seasonal allergy
Diagnostic Lab Data: Not yet. schedule for blood work
CDC Split Type:

Write-up: Tingling and numbness and cold sensation and warm to touch in legs/ pt started taking 2 tabs of Aspirin81 mg from yesterday/ still have the same symptoms


VAERS ID: 1208368 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Differential white blood cell count, Dyspepsia, Electrocardiogram, Fibrin D dimer, Full blood count, Laboratory test, Lipase, Metabolic function test, Pain in extremity, Sleep disorder
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Norethindrone Acet-Ehyl EST 1-20 mg-mcg for birth control.
Current Illness: Seasonal allergies.
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: CBC with differential, complete metabolic panel, lipase, D-dimer for venous thromboembolism, EKG. Lab results and EKG were unremarkable.
CDC Split Type:

Write-up: Upper abdominal pain started on 4/11/21 and on about night of 4/12/21 left calf pain woke patient up. Patient notified this PCP''s office with these symptoms on 4/13/21 at 10:28 at which time patient was referred to the hospital ER due to 6 known cases of women who had received Johnson & Johnson vaccine and developed rare type of blood clots and patient''s above symptoms to rule out deep vein thrombus. At the hospital ER provider did physical exam and ordered lab which confirmed patient had no deep vein thrombus. Patient was discharged home with diagnoses of left calf pain and dyspepsia. Patient continues to have abdominal intermittently but left calf pain has been resolved.


VAERS ID: 1208395 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dyspnoea, Neck pain, Oropharyngeal pain, Pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breathe, severe neck and shoulder pain while breathing, body pains, throat pain


VAERS ID: 1208426 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen, Fatigue, Laboratory test, Lymphadenitis, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvance
Current Illness: none
Preexisting Conditions: none
Allergies: Chicken
Diagnostic Lab Data: Abdominal Cat Scan, blood work and urine tests. All normal except for Cat Scan taking 4/13/2021 around 5:30 pm.
CDC Split Type:

Write-up: Patient received the Janssen COVID-19 Vaccine EUA April 12, 2021 and later that evening started developing severe abdominal pain that would not go away. Following day it was still there, so we took her to the Emergency Room where after an abdominal cat scan she was diagnosed with mesenteric adenitis. They gave her total to manage the pain and sent her home to let the symptoms subside hopefully after a few days. Today she is better, but very tired.


VAERS ID: 1208446 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Hyperhidrosis, Laboratory test, Magnetic resonance imaging, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sumatriptan
Current Illness:
Preexisting Conditions: Asthma
Allergies: Minocycline and raw fruit
Diagnostic Lab Data: In the past, the patient had experienced a few cases of blackout migraines. To address the issue, she saw a neurologist and had blood work and an MRI, but the neurologist could not find the issue.
CDC Split Type:

Write-up: Patient was experiencing convulsions the evening/night of the vaccine administration. She also experienced shivers and had back pain. However, it was reported the patient is prone to back pain. Post convulsion, the patient was experiencing extreme sweating.


VAERS ID: 1208478 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: History of Present Illness The patient presents with 50-year-old male with a history of hypertension and diabetes who presents via private vehicle with complaints of atraumatic left calf pain x4 hours. Symptoms started while typing on computer at work sitting in chair. Described as mild soreness to his left medial calf rating behind his knee. No frank tenderness with palpation. No fall, trauma, injury, or overuse syndrome including gym. No swelling, edema, or asymmetry. No associated motor/sensory disturbance able to wiggle and feel all digits with good pulses. No chest pain, shortness breath, palpitation, lightheadedness, or syncope. No spasms, cramps, or charley horses. Patient denies any history or DVT/ PE, hypercoaguable disorder, recent immobilization or surgery, recent long trips or travel, or active malignancy (w/ treatment in last 6 months) but does take prescribed clomiphene for androgen replacement/stimulation. Discomfort scribed as soreness, minimal intensity, 2 out of 10 without provocative or palliative factors.


VAERS ID: 1208491 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-02
Onset:2021-04-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Night sweats, Pharyngeal swelling, Pyrexia, Rash, Rash papular, Rhinorrhoea, Skin burning sensation, Somnolence, Swelling of eyelid
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Taking Collagen, zinc, vitamin c and vitamin D3, melatonin (5mg), zyrtec, and ibuprofen as needed 500Mg of Valtrex
Current Illness:
Preexisting Conditions: fibromyalgia, hsv-2, ptsd
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 4 hours I experience chills, fatigue and a headache. Within 8 hours I had a fever and slept for the next 24 hours. I broke out in buckets of night sweats. The following 2 days I was generally fatigued and had sniffles. After that I was fine, until Monday night (Day 10). I suddenly experienced a sudden onset of a painful and raised red rash at the base of my spine on my lower back. Within hours it migrated up to my head, face and then to the front of my torso. My eyes and throat closed. I took benadryl with no relief. I called Dr. on Demand and they urged me if the symptoms got worse to head to urgent care/ER. The next day (Tuesday 4.13) I went to the ER where they gave me a steroid shot, and prescribed me predisone and Prilosec to block the histimines. I am still having rash symptoms,itchiness and burning. While I have a history of seasonal allergies they''ve always been stuffy nose at the most. We had no new dietary introductions or new habits.


VAERS ID: 1208555 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: She did have blt turbinate reduction 3 weeks prior to vaccine, but drainage had been clear for $g1 week prior to vaccine. Day after vaccine she had large blood clots from nares
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: multiple large blood clots from her nares on Monday 4/12


VAERS ID: 1208584 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Hot flush, Hyperacusis, Influenza, Nausea, Pain, Photophobia, Pyrexia, Tenderness
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women?s one a day multivitamin
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2:30 slight-mild symptoms: headache, body aches 4:20pm- 7am SEVERE flu symptoms: body aches, chills, hot flashes, headache, nausea, dizziness, sensitivity to light and sound, tinder, fever Treatment: Tylenol and cold rag


VAERS ID: 1208616 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: headache, cramping by her hip, pain in her legs


VAERS ID: 1208650 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

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

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

Write-up: Headache, nausea, body aches, chills and fever ranging from 99 to 101 for a period of 24 hours. Ibuprofen helped with symptoms and alleviate some of the body aches.


VAERS ID: 1208680 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Amnesia, Anxiety, Aphasia, Blood pressure fluctuation, Computerised tomogram normal, Decreased appetite, Dizziness, Dysarthria, Dysphemia, Erythema, Fatigue, Feeling abnormal, Loss of consciousness, Magnetic resonance imaging normal, Mental status changes, Rash, 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), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: hypothyroidism
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan and MRI taken at hospitalization 04/12 - negative result
CDC Split Type:

Write-up: on the day of vaccination: rash, redness of face and shoulders and neck, vomiting, extreme fatigue these symptoms continued for 48 hours then I started to feel better on 04/12 around 6pm I started feeling foggy, dizzy and felt like I was going to pass out. I called the neighbor for help. I couldn''t communicate, my body was shaking, trembling, I stuttered as I was trying to form words. I was taken to hospital by ambulance. I was unable to speak, I was shaking and my blood pressure went up and down. I was given IV fluids and Ativan for anxiety, dysarthria and altered mental state. As of 04/14 I have memory loss, loss of taste and appetite, extreme fatigue


VAERS ID: 1208682 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Injection site pain, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Nausea beginning around 7:00 p.m. followed by chills, fever of 100 F, and vomiting on and off for several hours. Joint pain in shoulder near injection site and right hip.


VAERS ID: 1208711 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Hyperhidrosis, Influenza like illness, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wixela Inhub, albuterol rescue inhaler as needed, Nasalcrom nasal spray, Oxylent multivitamin, vitamin D3, K2, milk thistle, and other herbs (nettles, sage, rosemary, thyme) in an infusion.
Current Illness: Recently had labs at yearly visit, TSH was high, TPO high, antithyroglobulin antibodies elevated.
Preexisting Conditions: asthma
Allergies: Penicillin (anaphylaxis), sulfa (hives), tetracycline, amoxicillin, shellfish (hives), latex/adhesive, some food sensitivities/oral allergies.
Diagnostic Lab Data: None. I did not go to the doctor for this adverse event from the J and J vaccine - I just stayed in bed like one does with a flu.
CDC Split Type:

Write-up: I had J&J vaccine around 12:30 on 4/12/2021. No issues at all until 11 p.m., started with sudden onset high fever (103), shaking chills, mild short-lived nausea, and immediate thumping splitting headache and very severe body aches and joint pain. In bed until 12 noon the next day feeling terrible. On couch rest of day with fever fluctuating from 100.3 to 101.1. Went to bed 4/13/2021 with 101.1 fever, woke up 5-6 times drenched in sweat (fever trying to break?) and then was able to get out of bed, fever resolved. Still achy and puny on 4/14/2021 but much better. I took NO medications during the side effects/adverse events from the J&J vaccine. I do have significant left arm pain at the injection site still on 4/14 but there was no redness, warmth, or rash at the site, arm looks completely normal. Very typical flu like reaction.


VAERS ID: 1208743 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-22
Onset:2021-04-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Xanax as needed at bed, 1-2 mg. Motrin, as needed
Current Illness: None
Preexisting Conditions: Fibromyalgia Diagnosis 2004
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2 weeks from the date of injection I began to experience moderate to severe pain at the injection site. I am still experiencing this issue as of today, 4/14/21.


VAERS ID: 1208756 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Gaze palsy
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin 150 mg x 2 Humira 40mg semi monthly Omeprazole 40mg daily Claritin Multivitamin
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache, shortness of breath, fatigue


VAERS ID: 1208780 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: methenamine, cephalexin, and microgestin fe.
Current Illness: kidney infection
Preexisting Conditions: Fetal hydronephrosis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain on left back shoulder extending down under the arm. Shooting pain down left leg.


VAERS ID: 1208790 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: A FAMILY ASKED IF THE MOM, DAD, AND THEIR TEENAGE BOY (AGE 17 AND 11 MONTHS) COULD GET THE COVID VACCINE AT OUR LOCATION. WE LOOKED ON THE WEBSITE FOR THE AGE LIMITS, AND IT LISTED AGES 16 AND UP COULD RECEIVE THE COVID VACCINE. WE PROCEDED TO GIVE THE VACCINE TO THE PARENTS AND THEIR SON ON MONDAY, APRIL 12, 2021. UPON FURTHER INVESTIGATION, WE FOUND THAT THE AGE LIMIT FOR THE JOHNSON AND JOHNSON COVID VACCINE IS ACTUALLY 18 YEARS OLD. WE NOTIFIED THE PARENTS, AND TOLD THEM OF THE SIDE EFFECTS TO WATCH OUT FOR AND IF THEIR SON EXPERIENCED ANY OF THESE, TO IMMEDIATELY CONTACT HIS PCP. WE ALSO NOTIFIED THE PCP OF THE EVENT AND EXPLAINED WHAT HAPPENED.


VAERS ID: 1208865 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21! / 1 RA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, Pruritus, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt experienced anaphylaxis with 1st dose of Pfizer cov19 vaccine, but patient wanted to be fully vaccinated due to losing a family member to Cov19. Patient was instructed by her Md to get the Janssen vaccine instead of the 2nd dose of Pfizer vaccine that was due on 3/28. A few minutes after the injection, the patient became itchy and had increased respiratory rate. Despite using her inhaler and receiving a dose of liquid Benadryl, the patients breathing worsened, and I injected the patient with an Epipen. Patients breathing improved and we monitored her for an hour before releasing her. A follow-up call was made on 4/13 to confirm the patient was stable.


VAERS ID: 1208892 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Dizziness, Hypoaesthesia, Oxygen saturation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: We do not have a history in the pharmacy for this patient
Current Illness: No history in the pharmacy system
Preexisting Conditions:
Allergies: PVK, Aspirin, and Lidocaine
Diagnostic Lab Data: BP (low but normal for the patient) PulseOx 98%
CDC Split Type:

Write-up: Immediately after administration patient felt extremely dizzy and about to faint. We placed her on the floor with her feet elevated. Placed an icepack behind her neck. Patient never lost consciousness. But, since patient was reporting a "body buzz" we called 911 to be on the safe side since patient has severe allergies. Paramedics came, checked the patient and decided she did not need further treatment.


VAERS ID: 1208956 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Flushing, Oropharyngeal pain, Paraesthesia oral, Periorbital swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol ER 50mg 1 qd, Triamterene-HCTZ 37.5-25mg 1 qd, Duloxetine HCL 30mg 1 qd, Vit D3 50000 units 1 q week, Loratadine 10mg 1 qd, Alli
Current Illness: None
Preexisting Conditions: Htn OSA
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 4/12/21 12:30 pm began to feel fatigued, face felt flushed. No fever. Fatigue increased more in the evening. 4/13/21 2:30 am awoke and found entire face swollen and slight tingle in lips. Took Loratadine, Metoprolol and Triamterene/HCTZ and went back to bed. Awoke at 5 am, swelling better, but not gone. Still very puffy above and below eyes. Felt fatigue, no fever, went to work. Felt better by lunch time, swelling almost gone. 4/14/21 Slight sore throat, slight fatigue, no swelling.


VAERS ID: 1208986 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Injection site pain, Injection site warmth, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: HPV (Gardasil 9): passed out
Other Medications: Birth control: Levonor/Eth Estradiol, Vital Proteins Collagen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 0-9 hours after injection: slight soreness and feeling of heat in arm of injection. 9 hours after injection: chills. 16 hours after injection: nausea, light headed, fever, headache, soreness and achiness in arm of injection - took Tylenol. 24 hours after injection: symptoms started to get better, headache still present. 40 hours after injection: headache still present- still taking Tylenol and by 48 hours symptoms almost completely gone. (Continuously took Tylenol every 6 hours or so)


VAERS ID: 1209006 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Full blood count, Heparin-induced thrombocytopenia test, Oedema, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VICKS CREAM
Current Illness: NONE
Preexisting Conditions: MIXED HYPERLIPIDEMIA /, MAJOR DEPRESIVE DESORDER ,/ SPINAL ENTHESOPATHY LUMBASACRAL REGION
Allergies: CODEINE AND CITALOPRAM
Diagnostic Lab Data: CBC PENDING RESULT HEPARIN-INDUCED THROMBOCYTOPENIA PENDING RESULT
CDC Split Type:

Write-up: PATIENT REPORTS BEGINNING TO FEEL PAIN IN THE LEFT ARM FROM THE SAME DAY OF THE VACCINE AND THE PAIN WAS INCREASED, FEELING THE HOT AREA AND ON THE THIRD DAY PERSISTENT PAIN, EDEMA, ERYTHEMA


VAERS ID: 1209041 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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:
Other Medications: birth control only
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mild seizure, passed out


VAERS ID: 1209098 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-03
Onset:2021-04-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Dyspnoea, Headache
SMQs:, Anaphylactic reaction (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide 50mg Trokendi 50mg Amplodipine besylate 10mg Levothyroxine 75mg Metoprolol succ er 50mg Burrowing hcl xl 150mg
Current Illness: High blood pressure/normalized Thyroid/ normalized
Preexisting Conditions: High blood pressure/normalized Thyroid/ normalized
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache Stomach problems Shortness of breath


VAERS ID: 1209141 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

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

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

Write-up: A FAMILY ASKED IF THE MOM, DAD, AND THEIR TEENAGE BOY (AGE 16 YEARS AND 3 MONTHS) COULD GET THE COVID VACCINE AT OUR LOCATION. WE LOOKED ON THE WEBSITE FOR THE AGE LIMITS, AND IT LISTED AGES 16 AND UP COULD RECEIVE THE COVID VACCINE. WE PROCEEDED TO GIVE THE VACCINE TO THE PARENTS AND THEIR SON ON MONDAY, APRIL 12, 2021. UPON FURTHER INVESTIGATION, WE FOUND THAT THE AGE LIMIT FOR THE JANSSEN COVID VACCINE IS ACTUALLY 18 YEARS OLD. WE NOTIFIED THE PARENTS, AND TOLD THEM OF THE SIDE EFFECTS TO WATCH OUT FOR AND IF THEIR SON EXPERIENCED ANY OF THESE, TO IMMEDIATELY CONTACT HIS PCP. WE ALSO NOTIFIED THE PCP OF THE EVENT AND EXPLAINED WHAT HAPPENED.


VAERS ID: 1209149 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-22
Onset:2021-04-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec OTC aspirin
Current Illness: None known
Preexisting Conditions: Multiple DVTs in the past per patient report.
Allergies: Morphine
Diagnostic Lab Data: Venous Doppler US confirms DVT. (4/12/21)
CDC Split Type:

Write-up: Note: Initial date is an estimate based on patient scheduled to get 2nd dose on 4/19. Patient with acute DVT noted. Note, per patient, he has a history of multiple DVT in the past and was prescribed to be on medication for this, which he stopped years ago. Patient placed on anticoagulation for acute DVT, seeing specialty to look for possible cause of hypercoagulability. Patient saw me first for diagnosis of acute DVT, so history prior to this is limited and based on patient''s report.


VAERS ID: 1209185 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Headache, Immediate post-injection reaction, Paraesthesia oral, Tinnitus
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Hypersensitivity (narrow)

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

Write-up: **Tingling in my tongue immediately after the shot--lasted about an hour then turned into a light metallic taste in my mouth that lingers still **Debilitating headache for first 24 hours **Ringing in my ears since Monday evening


VAERS ID: 1209216 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Peripheral swelling, Skin discolouration, Thrombosis, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 120 mg Verapamil
Current Illness: None
Preexisting Conditions: Splenectomy 1983 Inter Cardia Defibrillator (ICD) 2005-Torsades de pointes ventricular tachycardia
Allergies: None
Diagnostic Lab Data: Date 04/13/2021 - Ultra Sound at Hospital -Confirmation of Blood Clot in upper right shoulder . Scheduled to see Vascular Specialist next week.
CDC Split Type:

Write-up: Blood Clot-Bad swelling in right arm. Arm tingling, numbness and discolored. Arm is swollen from top of arm to fingers. Notice first sign on Monday morning (04/12/2021) when i awoke from bed around 7:00am.


VAERS ID: 1209238 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Tenderness, Toothache
SMQs:

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

Write-up: Very bad headache that started on Monday night... progressed all day on Tuesday. I started feeling better when I woke up on Wednesday. The pain was in the left temple. It was also hurt to touch it. My face and teeth also felt some pain. On Wednesday morning, the headache started to go away but I could still feel it very slightly


VAERS ID: 1209269 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

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

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

Write-up: No adverse event, vaccine was given to a person 17 years old and vaccine is not approved for this age.


VAERS ID: 1209278 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NO
Preexisting Conditions: THYROID
Allergies: NONE
Diagnostic Lab Data: STILL WAITING AT THE DOCTOR''S OFFICE
CDC Split Type:

Write-up: SWELLING AT THE LEFT NECK REGION. IT IS LITTLE HARD AND PAINFULL WHEN PRESSED ON THE SWELLING SITE.


VAERS ID: 1209368 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zoloft 100mg, Mirena
Current Illness: NA
Preexisting Conditions: NA
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, sweating, muscle pain, fatigue, headache from 11pm on day of dose, 4/12/21, until morning of 4/14/21. Fever dissipated after roughly 12 hours, additional symptoms continued. By 4/14/21, feeling much better, though generally tired/light fatigue.


VAERS ID: 1209372 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amylase, Arthralgia, Blood thyroid stimulating hormone, Burning sensation, C-reactive protein, Chest pain, Dyspnoea, Full blood count, Lipase, Metabolic function test, Pain in extremity, Peripheral swelling, Red blood cell sedimentation rate, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dexilant 60 mg once a day
Current Illness: Esophageal reflux
Preexisting Conditions: Lumbar spondylosis Renal calculus Anxiety
Allergies: NKA
Diagnostic Lab Data: Venous doppler done 04/13/21 - reported as negative by patient - done at outside facility. Labs done 4/14/21 include CBC, CMP, TSH, ESR, CRP, amylase, lipase
CDC Split Type:

Write-up: Lower extremity swelling, leg pain, burning in the ankle, chest pain, shortness of breath, shoulder blade pain


VAERS ID: 1209384 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zoloft 100mg, Mirena
Current Illness: NA
Preexisting Conditions: NA
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, sweating, muscle pain, headaches, fatigue. Began by 11pm on the day of shot, 4/12/21, lasted through 4/13/21, and began to feel much better 4/14/21, though still very tired/light fatigue.


VAERS ID: 1209385 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bedridden, Dizziness, Dysphagia, Dyspnoea, Hypoaesthesia oral, Odynophagia, Pharyngeal swelling, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: tested pos for covid-19 on february 25th and tested negative on march 31st.
Preexisting Conditions: n/a
Allergies: alcohol
Diagnostic Lab Data:
CDC Split Type:

Write-up: i received the vaccine at 3pm on monday april 12th. i started shaking less than 5 minutes after i received the dose and my throat started to swell and i couldn?t swallow. they placed me under observation for 30 minutes and gave me water?saying that ?i might just be afraid of the needle and not to worry, this is an abnormally normal reaction to a new vaccine.? after 30 minutes a man walked over to me and said ?oh you?re still here?? and chuckled. they then told me i would be fine after a while and to leave. i started walking down the sidewalk and almost passed out so i called an uber to take me to the nearest urgent care. i arrived at urgent care around 4pm unable to swallow and having a reaction to the vaccine. they saw me immediately and gave me 3 50mg of prednisone and a benadryl and placed me under observation for 45 minutes. he said i looked better and i even felt marginally better. i called another uber and when i was almost home my tongue started to go numb as well as my lips and my breathing was becoming constricted. i had the uber driver pull over as i had to sit on the sidewalk and get some air. i then called another uber to the hospital because my symptoms were becoming increasingly more alarming. Hospital admitted me and gave me a shot of epinephrine and IV fluids and kept me under observation for 6 hours. they discharged me a little after midnight with a prescription for prednisone, epinephrine, and benadryl. if i had been administered epinephrine at the vaccine site on monday and not been told i was just squeamish by the male air force cadets?i probably wouldn?t still be short of breath, painfully swallowing, and bedridden.


VAERS ID: 1209391 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: On Monday 4/12/21, 5 days after taking the J&J vaccine, I had an extremely itchy and painful full body rash. It was big red bumps like mosquito bites all over my body including legs, back, arms, chest, stomach, etc..I could not sleep all night due to the pain and itch and had to constantly apply cortisone cream as well as ice to make the pain bearable. The rash went away almost completely the following morning but then returned again the following night. I have never had any prior allergies or skin conditions and worry that this may become a recurring event since it has now happened for 2 nights. I did hear that a rash at the injection site was a possible side effect from the covid vaccines but this was way worse as it was all over my entire body.


VAERS ID: 1209418 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Respiratory arrest, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: patient mentioned history of syncope after vaccination, details unknown
Other Medications:
Current Illness:
Preexisting Conditions: History of syncope post vaccination
Allergies:
Diagnostic Lab Data: Pulse ox remained at 99 throughout event.
CDC Split Type:

Write-up: Patient experienced extended episode of syncope and temporary discontinuation of respiration approximately 8 minutes after vaccination.


VAERS ID: 1209477 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Gaze palsy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Ocular motility disorders (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? No
Hospitalized? No
Previous Vaccinations: ADEM reaction from annual flu vaccine, 9 years old, late 2008
Other Medications: Cannabis
Current Illness:
Preexisting Conditions: Acute disseminated encephalomyelitis (ADEM)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Slight muscle pain in both arms, shoulders, and upper back; sporadic headaches and general fatigue.


VAERS ID: 1209488 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, Pruritus, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D 3
Current Illness: none
Preexisting Conditions: allergies
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: swilling in arms redness itching with fever


VAERS ID: 1209507 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Headache, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Abdominal pain Headaches Hives In my head


VAERS ID: 1209695 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Epistaxis, Eye irritation, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Corneal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, body pains, shivers, nose bleed, burning sensation of eyes


VAERS ID: 1209712 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Hypoaesthesia, Pain in extremity, 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), Tendinopathies and ligament disorders (broad)

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

Write-up: headahce, lightheaded, sob, calf pain, numbness, tingling


VAERS ID: 1209764 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-19
Onset:2021-04-12
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Antibody test, Blood glucose, Blood test, Electrocardiogram, Facial paralysis, Full blood count, Hypoaesthesia, International normalised ratio, Lyme disease, Metabolic function test, Prothrombin time, Troponin
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No home medications.
Current Illness: No significant PMH
Preexisting Conditions: No significant PMH
Allergies: NKA
Diagnostic Lab Data: Medication Dose Route Sodium Chloride 0.9% 1000 mL Initial Volume 30 mL/hr IV Right Antecubital Foss iopamidol 75 mL IV Push predniSONE 60 mg Oral Radiology Orders: CT Angio Head/Neck Stroke 04/12/21 17:23:00 EDT, Stat, Reason for exam right facial droop, Transport Mode: Stretcher 04/12/21 17:23:00 EDT EKG 12 Lead 04/12/21 17:23:00 EDT, Stat, Stroke-TIA-Periph. Embolization, Once, 04/12/21 17:23:00 EDT, Laboratory Orders: ABO/Rh. Retype Blood, Stat, Collected, 04/12/21 17:33:00 EDT, Once, 299912316.000000 Antibody Screen Gel. Blood, Stat, 04/12/21 17:23:00 EDT, Once Automated Differential Blood, Stat, Collected, 04/12/21 17:33:00 EDT, Once, 299912313.000000 BMP Blood, Stat, 04/12/21 17:23:00 EDT, Once CBC w/ Differential Blood, Stat, 04/12/21 17:23:00 EDT, Once Glucose POCT Blood, RT collect, Collected, 04/12/21 17:27:20 EDT, Once Group & Rh Blood, Stat, 04/12/21 17:23:00 EDT, Once Lyme Disease Acute Reflexive Panel ARUP Blood, Stat, 04/12/21 17:25:00 EDT, Once PT/INR Blood, Stat, 04/12/21 17:23:00 EDT, Once PTT Activated Blood, Stat, 04/12/21 17:23:00 EDT, Once Troponin-I Blood, Stat, 04/12/21 17:23:00 EDT, Once
CDC Split Type:

Write-up: Sudden onset of facial droop and facial numbness


VAERS ID: 1209775 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, amlodipine, atorvastatin, carvedilol, and metformin
Current Illness: None reported
Preexisting Conditions: Diabetes and high blood pressure
Allergies: No known drug allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient reported leg cramps that started in left calf and migrated to left thigh/groin area between 12am and 1am on 4/12/2021. Patient reported symptoms at approximately 7:00pm on 4/13/21. Symptoms lasted approximately 20 minutes and have since resolved. Patient reports no other symptoms (patient was questioned about back pain, abdominal pain, shortness of breath, and headache).


VAERS ID: 1209820 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Diarrhoea, Full blood count, Nausea, Pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None at time of vaccination. Tylenol after vaccination on 4/8. One dose of NSAID given at urgent care on 4/13. Two dose Tylenol 4/13 at home 12 hours apart.
Current Illness: None
Preexisting Conditions: Proximal superventricular tachycardia. PFO with atrial septum aneurism. No medications taken for either. No restrictions other than scuba diving.
Allergies: No
Diagnostic Lab Data: Primary doctor would not see anyone in the office with Covid symptoms. So I went to an urgent care, and saw a nurse practitioner. Covid test (negative) CBC ordered (awaiting results) Given fluids via IV with zofran and toradol
CDC Split Type:

Write-up: On the evening of 4/7, very achy and sore arm and mild fever. Recovered and felt fine by the evening of 4/8. On 4/12 Began feeling nauseous, and was throwing up all night, along with diarrhea. Severe lower back, knee, hip and outer thigh pain. On morning of 4/13 had a fever of 102, very nauseous. Still very sore. On 4/14 still achy in lower back and hips and thighs, temperature is closer to normal.


VAERS ID: 1209901 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothroxin 10mg buspar 10mg trazadone 30mg
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache Nausea chills fever dizzy


VAERS ID: 1209918 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Head discomfort, Headache
SMQs:

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

Write-up: J&J COVID-19 Vaccine EUA About 6 hours after injection I experienced severe chills for about 90 minutes, followed by a headache overnight. Only mild head pressure was felt the second day.


VAERS ID: 1210035 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-13
Onset:2021-04-12
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye haemorrhage, Ocular discomfort, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retinal disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Positive for COVID-19 in early February. Second test negative
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately a week after vaccine administration a rash developed on torso. Then on April 12, 2021 after working throughout the morning sitting in front of my computer, I took a lunch break. While preparing a meal, I felt discomfort in the left eye and it became very uncomfortable. When I checked in the mirror, I discovered my left eye was filling with blood. Upon seeing an eye doctor that same afternoon, the doctor explained that my left eye had ruptrued a large vessel and hemmoraged. However, the reason for the hemmorage could not determined because I was not under stress, had not lifted anything heavy, was not on blood thinner medication, was not constipated and have no underlying health condition.


VAERS ID: 1210085 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Laboratory test, Loss of consciousness, Vision blurred, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Cymbalta , Atorvastatin, Lisinopril
Current Illness: None
Preexisting Conditions: Pre-diabetic, high cholesterol
Allergies: Latex
Diagnostic Lab Data: Went to ER, did some sort of Blood test that said "I didn''t have any blood clots". Did not have a cat scan or MRI. Said I was mildly dehydrated, gave me fluids. Ate dinner, vomited, and had another dizzy/blurred vision at 724 pm.
CDC Split Type:

Write-up: I have been very dizzy, blurry vision, black out and vomited this evening around 6pm. 4/14/21


VAERS ID: 1210094 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

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

Write-up: Patient was 17 years of age and received the Janssen shot at covid immunization clinic provided by Pharmacy. No issues at time of immunization.


VAERS ID: 1210150 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Diarrhoea, Dizziness, Impaired work ability, Mobility decreased, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin ? rash Bee stings ? body aches and swelling Shell fish ? sometimes swelling of moth and lips Hay fever allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea and dizziness by evening. Nausea increased. Woke up at 11:45 pm and went to the bathroom. Could not get up from toilet. Too dizzy. Called husband to help. Threw up three times. Body aches and chills came on very quickly. Body aches became severe. Returned to the bathroom about 30 mins later and had bowel movement and some diarrhea. Difficulty sleeping due to the pain from body aches and chills. Fever developed by morning. At 6:00 am fever was 99.8. Took one Advil. Fever subsided. Slept off and on all day. Body aches and chills lasted most of the next day on 4/13. By 4/14 symptoms lessened. Still feeling queasy in the stomach and weak. Headache in the afternoon around 3:45 pm after waking up from a 30 min nap.


VAERS ID: 1210202 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Muscle twitching, Nervousness
SMQs:, Dyskinesia (broad), Dystonia (broad), Hypoglycaemia (broad)

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

Write-up: I?ve received the vaccine on Sunday and have been having nervous twitching ever since. It has now been over 72 hours since I?ve received the vaccine and the nervous twitching up until now is starting to get worse.


VAERS ID: 1210262 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Headache, Neck pain, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levithyroxine, carvedilol, Doxazosin, Wixela, Montelukast, Rosuvastatin, Sulfasalazine, vitamin D3, calcium
Current Illness:
Preexisting Conditions: Arthritis, asthma, high blood pressure, hypothyroidism,
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe headache, stomachache, muscle aches especially in the neck


VAERS ID: 1210366 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 5:00pm on day of vaccine I began feeling a fever coming on. I had a fever on and off for the next 24 hours. With ibuprfen and tylenol, it never dropped under 99.4 until the following evening. 7:08pn 04/14 - I am feeling tingling in both my legs. It is ongoing now for almost 2 hours.


VAERS ID: 1210367 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-11
Onset:2021-04-12
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Chills, Fatigue, Headache, Hyperhidrosis, Nausea, Pain, Pyrexia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Iron, Vitamin B-12, Vitamin D, Tri-cyclen birth control, Lexapro
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Full body aches and pains, fever, chills, sweats, severe headache, nausea, chest pain/pressure, fatigue but not being able to sleep due to intense pain.


VAERS ID: 1210397 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Paraesthesia oral
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

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

Write-up: Tingling sensation around the mouth area 2 days prior, eruption of blisters under the nose on the 3rd day, similar to cold sores. Patient did not have prior episodes of cold sores.


VAERS ID: 1210420 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dysgeusia, Immediate post-injection reaction, Pain
SMQs:, Taste and smell disorders (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, omega 3 supplement
Current Illness: None
Preexisting Conditions: Sleep apnea w cpap
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Near immediate metallic taste in my mouth. Resolved after 36 hours. Body aches developed within 8 hours. Resolved in 36 hours


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