National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

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



Case Details

This is page 52 out of 80

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80   next


VAERS ID: 1374205 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-12
Onset:2021-05-30
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A2114 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atypical pneumonia, Back pain, Chest X-ray, Computerised tomogram thorax, Cough, Headache, Urine analysis
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Infective pneumonia (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: X-ray of the chest CT scan of the chest with contrast
CDC Split Type: vsafe

Write-up: I was okay for the first two weeks I went to the ER on 05-30-2021 due to cough, slight headaches, pain in my back. I came to find out the pain I was experiencing was "walking pneumonia". At the ER x-rays of the chest, CT scan of the chest with contrast , UA were performed. I was given albuterol inhaler and z-pack and Oxycodone for pain. I still have bit of pain to my back and slight headaches that come and go.


VAERS ID: 1374219 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-12
Onset:2021-04-20
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arteriogram carotid, Balance disorder, Blindness unilateral, Cerebrovascular accident, Chest X-ray, Computerised tomogram head, Hemiparesis, Impaired driving ability, Laboratory test, Magnetic resonance imaging head abnormal, Mobility decreased, Quality of life decreased, Spinal X-ray, Walking aid user
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metforma 1000 mg twice daily Jardiance 10mg 1 day
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: None
Diagnostic Lab Data: CT head scan, Ct scan of Carotid arteries, Xray of back and chest, MRI Many Lab tests
CDC Split Type:

Write-up: April 20, 2021. PT needed to use the restroom. We stopped, he walked to the restroom, I went to the gift shop. Upon returning, I saw PT sitting on a bench. He was leaning to his left, could not see out of his left eye, very unstable when sitting. We missed lunch, so we thought it was his sugar dropping. I started to feed him jam and a chocolate bar. After 2 hours, his vision returned & he seemed better. He drove us back to the rental cabin. He rested the next 2 days. Then on Friday, we packed up our vehicle and Pt drove us back home. After arriving home, Pt''s condition got worse. We went to the Dr, explained the events of the previous week & she came to the same conclusion, Diabetes spell. His condition continued to worsen, we went back to Dr several times, the ER 2 times and finally we got into see a Neurologist. That appointment, the doctor said he thought stroke. Dr scheduled a MRI for June 1, 2021. Results of that MRI was a definite stroke. Now he has started outpatient rehab with no promise he will ever regain full mobility. He can no longer drive, mow grass, walk without a cane and help, etc. Life has changed dramatically for both of us.


VAERS ID: 1374263 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-03-13
Onset:2021-03-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Headache, Migraine, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (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:

Write-up: Headaches, migraines, sensory issues.


VAERS ID: 1374279 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-04-01
Onset:2021-04-22
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Blood test, Dehydration, Dyspnoea, Renal disorder, Renal failure, Sluggishness, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: I was taking Flexeril, Norco, Sulindac, Gabapentin, Amloditin, Apresoline, Losartin, Dymista, Boltaren gel, Ditrotan, Fluoxetin, Lovastatin, Albuterol, Duloxetine, Cored, Reglan, Protonix, Estrabiol, Zytex, Aspirin.
Current Illness: No.
Preexisting Conditions: I have high blood pressure, high cholesterol and heart condition.
Allergies: I am allergic to Ematrix.
Diagnostic Lab Data: blood work ultrasound
CDC Split Type: vsafe

Write-up: I was at work and feeling sluggish and couldn''t hardly breathe. I went to the hospital and was told my kidneys were failing and my blood pressure was dropping lower and lower. My kidneys were dehydrated and I needed to get fluids.


VAERS ID: 1374296 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-01
Onset:2021-05-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Herpes zoster, Pain of skin, Rash, Scab, Skin burning sensation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: shingrix
Other Medications: Atorvastation Eliquis HCTZ Trazodone Venlafaxine (none new)
Current Illness: none
Preexisting Conditions: Cardiomyopathy, pacemaker, hypertension, hyperlipidemia
Allergies: Shingrix Procaine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient went to urgent care on 5/30/21 with a rash on her upper arm. This appears to be shingles with the distribution and vesicles that were fluid-filled. She was given prednisone orally. I am seeing her 5 days later and she has a scabbed over rash in a dermatomal distribution that still stings and burns. No other contact dermatitis risk factors. I think this is Herpes Zoster.


VAERS ID: 1374300 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-13
Onset:2021-06-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Cardiolipin antibody negative, Deep vein thrombosis, Fall, Joint injury, Pain in extremity, Peripheral swelling, Thrombophlebitis superficial, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: B complex, Vitamin D3, biotin, MTV, probiotic, turmeric
Current Illness:
Preexisting Conditions: history of superficial vein thrombosis, varicose veins
Allergies:
Diagnostic Lab Data: Ultrasound 5/21/2021 - superficial thrombophlebitis Factor V and cardiolipin antibody 5/24/2021 - normal Ultrasound 6/3/2021 - DVT
CDC Split Type:

Write-up: On May 15th, she got the J&J vaccine. Then on May 17th, while she was walking, she tripped on a curb and fell and then landed on her left knee. Then, this past Thursday on May 20th, she noticed swelling and pain in the left leg. She presented to urgent care the following day on Friday and had an ultrasound done that revealed blood clot in the superficial veins. Patient recalls of had a similar episode of superficial vein clot about 6 years ago. Referred to vascular and second ultrasound done revealing DVT


VAERS ID: 1374363 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Pharyngeal swelling, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had an anaphylactic reaction, her throat began to swell shut. She was given 3 doses of epinephrine 0.3mg SQ (left thigh, left thigh, and right thigh). 911 was called and EMS arrived in approximately 10 minutes, they proceeded to take her to the hospital. She was being monitored after the vaccine for 30 mins due to multiple allergies including anaphylactic reactions to bee stings and food allergies.


VAERS ID: 1374366 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-21
Onset:2021-05-24
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis, Chest X-ray, Nasopharyngitis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Fluoroquinolones such as Cipro which needs to be pulled of the market due to the horrific neurological and musculoskeletal side affects it causes.
Diagnostic Lab Data: Chest X-ray June 3, confirmed acute bronchitis.
CDC Split Type:

Write-up: Overall I am a very healthy guy, rarely get sick, and when I do quickly recover. I got a cold just about 2 months after receiving my COVID vaccine. After about a week of having the cold I developed bronchitis (confirmed via chest X-ray). I highly suspect that the COVID vaccine may be causing my immune system to overact to my cold causing this bronchitis. Again I have never had bronchitis in my life and I have always been healthy. Although impossible to prove this link, CDC please take this report seriously as my wife also has bronchitis right now and research what this is doing to our immune systems. Thank you.


VAERS ID: 1374409 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-26
Onset:2021-05-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201S21S / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood calcium decreased, Blood culture, Blood glucose normal, Blood lactic acid decreased, Blood sodium decreased, Computerised tomogram abnormal, Erythema, Glomerular filtration rate decreased, Haematocrit decreased, Haemoglobin decreased, Joint swelling, Pain, Platelet count normal, Procalcitonin, Red blood cell sedimentation rate increased, Skin warm, White blood cell count normal, X-ray limb
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad), Tumour lysis syndrome (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: 74 y.o. male presented to the ER with complaints of right elbow pain and swelling. The nursing home did call the office yesterday requesting for x-ray of the right elbow. Bed x-ray did show an impression of: Unremarkable limited view left elbow without evidence definite fracture or dislocation this was read by the radiologist. Patient did have CT scan right elbow today showed an impression of: Diffuse soft tissue edema prominence subcutaneous soft tissue gas along the dorsum forearm proximally, in no acute pathology or CT evidence of acute osteomyelitis, no vascular pathology. It is noted that patient has swelling, redness pain, and erythema to the right elbow. Upon examination the patient does grimace pain movement of the right level. Patient does have a large pocket of fluid noted to the right medial epicondyle region and to the medial right upper forearm. Skin is hot to touch, but patient''s pulses were noted at 2+ 2+, and CMS is less than 3 sec. Patient did also have lab work a white blood count noted of 5 point, hemoglobin is 10.4, hematocrit was 31, platelet count is 201. BMP showed a nonfasting glucose of 107, sodium was 135, calcium 8 1, and his GFR is 84. Patient''s sed rate is elevated at 45. Patient''s lactic acid noted at 0 4. Patient did also have blood culture in the emergency room and that result is pending. Patient''s procalcitonin level is noted at less than 0.00. The patient was started on vancomycin 1 g IV piggyback every 12 hr. Patient was admitted to medical inpatient as it deemed that he will need longer than a 2 midnight stay for monitoring and IV piggyback antibiotics.


VAERS ID: 1374414 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-04-29
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Pneumonia, Seizure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Systemic lupus erythematosus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: J18.9 - Pneumonia, unspecified organism N17.9 - Acute kidney failure, unspecified R56.9 - Unspecified convulsions


VAERS ID: 1374423 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-05-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Feeling abnormal, Pruritus, Rash, Skin burning sensation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitamin; Vit C; Vit D3; Fish Oil; B12; Probiotic; L-Tyrosine/caffeine /Yohimbine -Supplements for fat burning combo; DHEA and melatonin; Apple Cider Vinegar pills
Current Illness: no
Preexisting Conditions: auto-immune - Cheilitis Granulomatous - last time I had treatments for that was 2010 - collection of granuloma cells - lower half of face (usually) - had injection in lips
Allergies: aspirin products - possibly anaphylaxis; Macrobid - broke out in full body hives
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: I went to the gym - I did a shoulder and chest day at the gym about 3 or 4 hours after the vaccine. Everything was normal. At 04:00 the next day, I was at the gym and I was about to change my clothes - and I felt this wave of anxiety which is very unusual for me. I took off my top to change and I had a full body rash - it was everywhere and hadn''t been there an hour before. It was a histamine response that I was perceiving as anxiety. I was about 7 minutes from an ER, so I went to the Medical Center- nothing was swelling and I was able to breathe. They gave me two mls of Benadryl - they gave me a shot in the "tush." The other "cheek" got a steroid (but not prednisone) dexamethasone, I think. They also gave me Pepcid orally. Told to take Pepcid twice a day for 5 days. They gave me steroid - oral prednisone - three tablets - once a day for three days (20 mg). It stopped the allergic reaction. It was a miserable week or so. The next day, I did my cardio - I had such a bloom of hives on armpits - fire and itching at the same time. I did no physical exercise for about three days. Then I went back to my regular activities. I tolerated what was going on (I was exacerbating the symptoms) but the allergy was done. Every day it got better. At two weeks, I was totally fine. I have returned to all my regular activities.


VAERS ID: 1374522 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Clonic convulsion, Dysarthria, Hyperhidrosis, Hypotension, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10:17 BP 56/35 pulse 118 O2sat 98 10:20 pulse 70 O2sat 99 10:25 BP 79/53 pulse 56 O2sat 99 Then EMS arrived and took over BP monitoring
CDC Split Type:

Write-up: Following injection patient passed out, was diaphoretic and had low BP of 56/35. Became responsive then speech became garbled and went into seizure (posturing and clonic movement) for approximately 3 seconds. Called 911. Became responsive before EMS arrived and refused ambulance to the hospital.


VAERS ID: 1374531 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Fatigue, Influenza like illness, Sinusitis, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: escitalopram 10 mg tab, methyphenid 36 mg tab, tamsulosin .4 mg cap , vitamin D3, tumeric, vitamin b12.
Current Illness: none
Preexisting Conditions: history of sinisitus.
Allergies: erythromycin
Diagnostic Lab Data: Primary referred me to E.N.T. on I believe 05/28/2021. Urgent care doctor perscribed antibiotics on 06/01/2021.
CDC Split Type:

Write-up: That evening after the injection I hot very sick...flu like symptoms w/ temperature of 102 - 104 degrees. Symptoms started to fade after a few days. About a day or two after the injection I experienced extreme fatigue, Severe Sinus infection along with Tinnitus. Worst I have ever experienced. I have been put on anibiotics starting the evening of 06/01/2021 and am scheduled to see an E.N.T. doctor at the end of June 2021.


VAERS ID: 1374541 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-28
Onset:2021-05-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram, Fatigue, Influenza like illness
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not reported by patient
Current Illness: Not reported by patient
Preexisting Conditions: Not reported by patient
Allergies: Amoxicillin and flunisolide nasal solution reported via pharmacy dispensing system
Diagnostic Lab Data: Patient reports and EKG, however this was not confirmed with ER department.
CDC Split Type:

Write-up: Patient presented to the pharmacy on 6/4/21 to inform pharmacist that she did go to the emergency room on 5/29/21 due to severe shortness of breath and flu-like symptoms. She stated they did complete an EKG and did check for blood clots. She stated that they did not find anything significant and ruled out a blood clot at that time. She still states she feels tired, however the shortness of breath did resolve and she was discharged home without any further treatment necessary.


VAERS ID: 1374545 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Hypotension, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Immediately following injection patient passed out and was diaphoretic with a low BP of 56/35. Became responsive but speech garbled and then experienced seizure (posturing and clonic movement) that lasted 3 seconds. Called 911, became responsive before EMS arrived on scene and refused ambulance.


VAERS ID: 1374656 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-20
Onset:2021-06-02
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Platelet count decreased, Ultrasound scan abnormal, White blood cell count increased
SMQs:, Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient without a prior history or risk factors for DVT, developed acute DVT left leg confirmed by U/S; WBC mildly elevated and platelets were low. Treated with DOAC


VAERS ID: 1374696 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-27
Onset:2021-04-20
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blister, Chest pain, Dyspnoea, Herpes zoster, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC sleeping pills
Current Illness: None known
Preexisting Conditions: Recently diagnosed with osteoarthritis in left shoulder
Allergies: None known
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Had chest pain / hurt when breathing for several days. Went to urgent care & ER on 4/23/21. Everything was ''normal''. No rash at that time. Found a rash with blisters on my right breast on 4/27/21. Went to PCP on 4/28/21. Was diagnosed with shingles. I have never had shingles in my life.


VAERS ID: 1374698 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-29
Onset:2021-05-06
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Peripheral swelling, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

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:
Other Medications: Fluoxetine
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: 5/9/2021 Doppler ultrasound. found blood clot
CDC Split Type:

Write-up: Swelling of the right foot and leg. Went to ER and they performed a doppler ultrasound and found a blood clot in the lower right leg. Prescribed blood thinner. So far, the swelling has gone down


VAERS ID: 1375066 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Headache, Paraesthesia, Somnolence, Unresponsive to stimuli
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: seizure disorder history of synecope
Allergies: Tylenol, Zipro, Codeine, Valium, Advair, Hydrocodone, Nortriptyline, crabmeat, lobster
Diagnostic Lab Data: Per Hospital, receive 1 liter of fluids and had bloodwork done. Released from hospital to home at1813.
CDC Split Type:

Write-up: Reported he walked to health department from home. After administration of vaccine, complained of tingling in right hand and wrist at 1544. Drank some bottled water. Complained of feeling sleepy and a headache. Began nodding off and then became unresponsive. BP at 1600: 98/78. Pulse: 80. BP at 1607: 100/70. Pulse: 72. Was beginning to rouse around this time but drowsy. Respirations 16. BP at 1615: 86/60. 911 called. Taken to hospital via ambulance at 1628.


VAERS ID: 1375276 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram thorax, Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TYLENOL, TORADOL
Current Illness: UNKNOWN
Preexisting Conditions: HISTORY OF BRONCHITIS, COPD
Allergies: CEFACLOR
Diagnostic Lab Data: CXR 6/1/2021, CHEST CT 6/3/2021
CDC Split Type:

Write-up: PATIENT STATES SHE STARTED HAVING A COUGH AND SOB 5 DAYS AFTER GETTING VACCINE


VAERS ID: 1375293 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Dyspnoea, Rash
SMQs:, Anaphylactic reaction (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Desvenlafaxine ER 50MG Once a day, Quetiapine 50 MG Once a day
Current Illness: N/A
Preexisting Conditions: ADHD, Depression, Anxiety
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash all over body within 1 hour of the shot, Severe Lower Back pain Rash got worse and trouble breathing day after the shot


VAERS ID: 1375586 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Stridor, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: DENIED
Preexisting Conditions: NONE
Allergies: STRAWBERRIES
Diagnostic Lab Data:
CDC Split Type:

Write-up: 02:20 Patient received Ist dose of Janssen. 02:24 Patient complained throat felt like it was closing and difficulty breathing, audible wheezing and stridor. Given Epi Pen 0.3mcg IM Right thigh. 911 called. 02:26 Given 25 mg of liquid Benadryl PO. 02:30 BP 140/94 Pulse 96 RR 26. 02:34 EMTs arrived BP now 100/60 Pulse OX 97% Pulse 85. 02:40 Walked out by EMT and Paramedics to the ambulance.


VAERS ID: 1375610 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-26
Onset:2021-05-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Bronchitis, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 20 mg
Current Illness:
Preexisting Conditions:
Allergies: Pennicillin
Diagnostic Lab Data: 5/29 blood test for blood clots 5/29 tov6/2 abutirol mist therapy
CDC Split Type:

Write-up: Fever, bronchitus


VAERS ID: 1375696 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-12
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blindness unilateral, Blood test
SMQs:, Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: no known allergies, no drug abuse or illicit drug usage, no relevant medical history and not taking any medications
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: Blood test; Result Unstructured Data: nothing of note was found
CDC Split Type: USJNJFOC20210605555

Write-up: BLIND IN THE RIGHT EYE; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non alcohol user, and non smoker, and other pre-existing medical conditions included no known allergies, no drug abuse or illicit drug usage, no relevant medical history and not taking any medications. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, frequency once total, administered on MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-MAY-2021, the patient noticed some vision issues. Patient went to the emergency room approximately 3 weeks ago. Patient was then referred to the ophthalmologist. Patient has since gone blind in her right eye. Patient never had any vision problems before. The ophthalmologist confirmed that it wasn''t cataracts, glaucoma, macular degeneration, or optic neuritis. The ophthalmologist said that he has no idea what it could be. On an unspecified date in MAY-2021, Laboratory data included: Blood test (NR: not provided) nothing of note was found. Patient was hospitalized for unspecified number of days. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of blind in the right eye was not reported. This report was serious (Hospitalization Caused / Prolonged, and Disability Or Permanent Damage).; Sender''s Comments: V0: 20210605555-covid-19 vaccine ad26.cov2.s-blind in the right eye. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1375822 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-14
Onset:2021-05-25
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster, Intraocular pressure test, Ocular discomfort, Pupil dilation procedure, Retinogram
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: N/A
Preexisting Conditions: ASthma
Allergies: hysmanal. methocarbamol, Levaquin, codeine
Diagnostic Lab Data: Went to ER on May 29th because shingles is near my eye and causing vision problems. I had my eye examined by an opthamologist on the 29th in the ER and again today June 4th. Eye pressure dilation retina images
CDC Split Type:

Write-up: I developed Shingles on May 25th, 2021. Not sure if related but Ive heard of several other people getting shingles recently. Feels relevant to report.


VAERS ID: 1375849 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

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

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

Write-up: syncope right after vaccination, patient gained consciousness after few seconds. then he passed out again for few seconds, patient has phobia from needles , right after his second episode , he became extremely pale, started sweating heavily and his pupils dilated, the episode passed on its own, the paramedics still took him to the hospital to make sure he didn''t hurt his head when he fell.


VAERS ID: 1375959 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Dizziness, Dysphagia, Electrocardiogram normal, Fatigue, Hypoaesthesia, Immediate post-injection reaction, Nausea, Paraesthesia, Urine analysis
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 112 mcg
Current Illness: NA
Preexisting Conditions: Hypothyroidism
Allergies: Sulfamethoxazole
Diagnostic Lab Data: ER visit: Blood test, urine test, EKG (05/19/2021) - tests didn?t show any abnormalities
CDC Split Type:

Write-up: Right after the shot, symptoms lasted for over an hour: Nausea, fatigue, dizziness, difficulty swallowing, numbness and tingling in the hand. Two days after the vaccine: loss of sensation in both legs (from the knees down) , constant nausea, fatigue and dizziness. Almost three weeks after the vaccine (today): constant fatigue and dizziness, nausea


VAERS ID: 1375969 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 6 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: PATIENT HAS PREVIOUSLY EXPERIENCED POTS SYNDROM/CONDITION - PAROXYSYMAL ORTHOSTATIC TACHYCARDIA
Preexisting Conditions: UNKNOWN - NO HISTORY OF ANY NEUROLOGICAL CONDITION - NOT ILL ON DAY OF VACCINATION - NO HISTORY OF ADVERSE REACTIONS TO PREVIOUS VACCINATIONS
Allergies: NONE
Diagnostic Lab Data: NONE -
CDC Split Type:

Write-up: Patient received vaccine with no apparent issue - sat in our waiting area per request for anticipated 15 minute + stay - Approximately 5 minutes after vaccination patient began to experience dizziness - elevated legs with chair with patient in sitting position - a minute later patient became unresponsive and appeared to have fainted/lost consciousness. Activated 911 system with local fire department and with patient not responsive - lifted patient from chair and placed on floor with cushion for head and elevated legs slightly - the patient had a pulse and was breathing the entire time and when able to communicate informed us she has a POTS condition - at this time EMT services arrived and stayed with patient for approximately 15 - 20 minutes talking the entire time - no transport to hospital - no drugs administered - patient may have followed up with walk-in/ER services but did not require transport and was released by EMT services


VAERS ID: 1376036 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Disorientation, Dyspepsia, Loss of consciousness, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient passed out, was briefly unconscious in chair. She woke up and felt disorientated. She felt tingling sensation throughout body and a burning pain in stomach.


VAERS ID: 1376337 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-06
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neuralgia, Ultrasound scan, X-ray
SMQs:, Peripheral neuropathy (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Aspirin, Vicodin, Vioxx
Diagnostic Lab Data: Leg ultrasound - X-ray
CDC Split Type:

Write-up: Patient stated approximately 2 day after vaccination maybe up to a week she began to get left leg sensations (nerve pain). She first called an physician 2 to 3 weeks after the vaccination. Her physician told her to go to the E.R.


VAERS ID: 1376375 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-05-27
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZIA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypersensitivity, Injection site rash, Miliaria, Rash morbilliform, Rash pruritic, Sensitive skin, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: A rash developed on the arm of the injection soon after receiving vaccine, similar to a heat rash. Approximitely 8 days later, my entire body broke out in what looked like measles & hives. It was extremely itchy and sensitive; it was treated with steriod pack via Urgent Care, where the Dr. confirmed that this was an allergic reaction to COVID-19 vax.


VAERS ID: 1376412 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-05
Onset:2021-05-14
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Gingivitis, Lip ulceration, Mouth ulceration, Viral test negative
SMQs:, Severe cutaneous adverse reactions (broad), Systemic lupus erythematosus (broad), Oropharyngeal infections (narrow), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xyzal 5 mg BID, famotidine 40 mg BID, zileuton XR 1200 mg BID, hydroxycholorquine 200 mg BID, methotrexate 15 mg SC weekly, Gastrocrom 200 mg PO BID, cromolyn sodium nebulized 20 mg PRN, tramadol 100 mg BID, gabapentin 300 mg SID, Xolair 30
Current Illness: Being worked up for GI symptoms - had colonoscopy 3 days prior to vaccination (colonoscopy biopsy results normal)
Preexisting Conditions: Mast cell activation syndrome; mastocytic enterocolitis; extraglandular Sjogren''s syndrome. In diagnostic work up: history of chronic diarrhea not fully responsive to mast cell disease management, with intermittent hematochezia; current differentials include Crohn''s or Behcet''s
Allergies: Latex, morphine, gluten, dairy, nightshades
Diagnostic Lab Data: Viral culture swab - negative for growth 5/17/21
CDC Split Type:

Write-up: 6 weeks after vaccination developed severe diffuse oral ulcerations ($g50 ulcers) present on buccal mucosal margins, lips, gingivitis, oropharynx.


VAERS ID: 1376426 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Hyperhidrosis, Loss of consciousness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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: No medications reported
Current Illness: Patient reported other illnesses at time of vaccination.
Preexisting Conditions: None reported by patient
Allergies: No allergies reported by patient
Diagnostic Lab Data:
CDC Split Type:

Write-up: Went over pertinent information with patient including disclaimer regarding blood clots associated with J and J vaccine. Patient stated no issues and to proceed. When asked if there were any allergies or adverse effects from previous vaccine administrations, patient stated no issues at all. Once vaccine was administered, the patient immediately broke out in a deep sweat, and fainted. I immediately had one of my techs call 911, during this time patient started to seize/convulsions. We had patient at an angle while patient was convulsing. Once patient stopped convulsing, patient gasped for air and regained consciousness. I asked patient if she was doing ok and identified myself as the pharmacist. Patient stated that they remembered who I was but did not remember anything after the vaccine was administered. EMS was called and while they tried to set up a quick triage IV line, patient started to faint again but did not lose full consciousness. Patient was transported to ER.


VAERS ID: 1376553 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Systemic: Vomiting-Mild, Additional Details: Patient fainted but woke up very quick. Vomitted once the started feeling better. No signs and symptoms of allergic reaction. We called 911 and was checked on site. The 911 personales reported no issue but patient caregiver asked that patient to be checked at the ER.


VAERS ID: 1376569 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Headache, Loss of consciousness, Nausea, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Nausea-Medium, Additional Details: Possible Vasovagal reaction, out for a very short time, then had nausea, a bit confused, shakiness, headache


VAERS ID: 1376604 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cyanosis, Dizziness, Head injury, Hypertension, Loss of consciousness, Nervous system disorder, Seizure, Syncope, Tremor, Unresponsive to stimuli, Urinary incontinence, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (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), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypertension-Medium, Systemic: Neurological Disorder (diagnosed by MD)-Medium, Systemic: Seizure-Medium, Systemic: Shakiness-Medium, Systemic: Vomiting-Medium, Additional Details: after receiving the J&J vaccine on 6/5/21 about 1.5 minutes after administration the patient hit his head against the wall and was unconscious. the patient started to mildly seize and lips started turning cyanotic and the patient urinated himself. The whole episode lasting about 45 seconds. When the patient came to he informed me that was epileptic. I kept the patient in the supine position until the paramedics arrived on the scene shortly after.


VAERS ID: 1376628 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-05-27
Onset:2021-05-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Influenza like illness, Nausea, Paraesthesia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Patient states that in the first two days after vaccination, she experienced flu-like symptoms. Her symptoms progressed and became more severe with nausea, vomiting, fever, and "sleeping legs" (numbness, tingling). Pt''s mother called pharmacy on 6/3/2021 to express concern and pharmacist advised her to take daughter to emergency department. Follow-up calls to patient have gone unanswered.


VAERS ID: 1376731 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-23
Onset:2021-06-04
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Petechiae, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: PLT <3
CDC Split Type:

Write-up: Non-traumatic bruising. Petechiae in random areas of body. Denies history of bleeding disorders in self or family. PLT <3.


VAERS ID: 1376813 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown - patient does not fill RX here at Pharmacy
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no medications listed on vaccine form
Diagnostic Lab Data: blood pressure was around 40 at time paramedics arrived, started to climb to around 60 by the time patient was being carted off in ambulance.
CDC Split Type:

Write-up: Patient recieved Covid vaccination from our intern and 10 seconds later reported feeling dizzy and unwell. Pt sat down immediately in consult room but then fainted and fell out of the chair and landed face first on the floor and experienced seizing motions. Patient was out for 30 seconds to a 1 minute. The patient came to and reported feeling better, wanted to sit up and wanted water. A water bottle was provided for the patient. 911/paramedics were called and 3-5 minutes later the patient fainted with seizing motions again but was supported and did not fall out of chair again. shortly after the second fall, paramedics arrived and took over. patient ate 4.5 hours prior to vaccination and also reported never fainting before after or while getting a vaccine.


VAERS ID: 1376866 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Immediately after the vaccine was administered, the patient stated that she felt sick and light headed. I instructed her to remove her mask, place her head between her legs and take some deep breaths. Before she had completely bent over she lost consciousness and began seizing. She remained in the chair for the duration of the event and until the paramedics took her out of the pharmacy. I made sure she did not injure herself or fall out of the chair and when the event was over I called ED. I continued to monitor the patient until she was taken by paramedics.


VAERS ID: 1376875 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Feeling cold
SMQs:, Hypoglycaemia (broad)

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

Write-up: The patient was very nervous before the injection. Approximately 5 minutes post-injection, the patient felt very anxious and reported feeling cold. Her parents had her lay on the floor. I held an ammonia inhalant close to her. She was breathing normally, but visibly nervous. I asked about her medical history and parents reported a history of seizures. They said she normally experiences flashing lights before a seizure; but she did not report a prodrome. I called for an ambulance for her to be assessed. The parents asked for her to be hospitalized for a workup.


VAERS ID: 1376902 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea exertional, Pulmonary embolism
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity, Lymphedema, History of DVT, Psoriasis
Allergies: Iodine & Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced dyspnea on exertion and lightheadedness shortly after receiving vaccine. He continued with these symptoms until presenting to ER on 6/6/2021 and found to have extensive bilateral pulmonary emboli.


VAERS ID: 1377041 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-24
Onset:2021-06-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient received the COVID vaccine on 5/24/21. On 5/31/21, patient started to experience chills, fever, and cough, which continued to progress until 6/3/21, when patient presented to the ER. He tested positive for COVID in the ER and was noted to be short of breath and satting 88% on room air. Patient was admitted to the hospital on 6/3/21 for COVID treatment (remdesivir and dexamethasone).


VAERS ID: 1377051 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Musculoskeletal stiffness, Nausea, Opisthotonus, Posture abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dystonia (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No known medications or supplements.
Current Illness: No illnesses known at the time of vaccination or up to one month prior.
Preexisting Conditions: No known health conditions.
Allergies: No allergies to medications/foods.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I administered the Janssen COVID-19 vaccine to Client in the deltoid muscle of the left arm. She was seated in our observation chair when the friend she was with asked for a trash can because she was feeling nauseous. He stated that she has a phobia on needles, and nausea was common. I went back into the pharmacy after giving her a trash can. I then looked over at the observation chair and her friend stated she was going to pass out. She became stiff and arched back in her chair for a few seconds before slumping forward. We called EMS while placing an ice pack on the back of her neck. Once the ice pack was in place she became more alert and oriented. She vomited. We placed her laying down on her side until EMS arrived. She was alert and oriented at this time.


VAERS ID: 1377100 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-22
Onset:2021-05-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Fatigue, Headache, Pain, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: TIRED ACHY HEADACHE, PATICEAL RASH ON ANKLE


VAERS ID: 1377277 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Nausea, Swelling face, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 20 minutes after receiving Janssen vaccine patient started complaining of nausea, facial swelling and tightness in throat. Patient was given 50 mg P.O. Benedryl. Throat tightness persisted and patient started with a dry, hacking cough. Patient was given 0.5 mg IM epinephrine and paramedics were called. Patient was alert, oriented, and able to speak at this point in time. She was evaluated and transported to ER. Reports indicate that she received fluids, was observed, and eventally discharged later that evening.


VAERS ID: 1377321 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Fatigue, Headache, Pain, Pain in extremity, Vaccination site swelling
SMQs:, Neuroleptic malignant 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pcp referred her to our hotline for triage. Recommended pt go to Urgent Care asap for w/u and to f/u with her pcp.
CDC Split Type:

Write-up: Pt developed sore arm, Tmax to 102, fatigue and headache ~5 hours post vax, but these symptoms mostly improved within 24 hours. Vax site swelling (Left arm) increased to size of palm of hand and developed pain shooting down legs (R$gL) over the next few days. Today is 5 days post vax.


VAERS ID: 1377720 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-05-10
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Cardiac flutter, Cardiac monitoring normal, Cardiac stress test normal
SMQs:, Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypertension (narrow), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Plaquenil, Estrogen 24SE, and Xyzal
Current Illness: None
Preexisting Conditions: Rheumatoid arthritis and fibromyalgia
Allergies: Sulfur
Diagnostic Lab Data: Stress test and Heart Monitor
CDC Split Type: vsafe

Write-up: I felt a heart flutter in my chest my husband took me to the ER. My blood pressure was elevated. All test came back negative. I followed up with Cardiologist for Stress Test and Heart Monitor all the events happened on May 10. Nothing has been resolved.


VAERS ID: 1377764 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-05
Onset:2021-04-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Fatigue, Heart rate increased, Inflammation, Musculoskeletal chest pain, Pain, Palpitations, X-ray normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra (allergies)
Current Illness: Not feeling well, but did not know of any specific illness.
Preexisting Conditions: N/A
Allergies: Apples, peaches, cherries, pineapple, mangos, hazelnut, severe allergies to environmental allergens (pollen, animals, etc.)
Diagnostic Lab Data: CT Scan, X-Ray, EKG, all were normal.
CDC Split Type: vsafe

Write-up: Lots of fatigue 2 days after vaccine, sharp stabbing pain on left side that afternoon underneath breast, struggling to breathe, went to ER, ER thought it was blood clot in lung, found to have normal lung, take ibuprofen, pain lasted most of the day, more pain when breathing in, pain gradually faded but occasionally flared up for 2 weeks after the first adverse event. Had been having some mild symptoms previous to that, medical people concluded it was inflammation exacerbated by vaccine. Palpitations, rapid heart rate.


VAERS ID: 1377774 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Computerised tomogram, Dizziness, Eye movement disorder, Fall, Headache, Muscular weakness, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: localized swelling at injection site.
Other Medications: Loratidine, Oxybutin, Simvastatin, Levothyroxine, Metoprolol, Pantoprazole
Current Illness: No
Preexisting Conditions: High blood pressure, High cholesterol, Obesity
Allergies: Neomycin, Erythromycin, Sulfa drugs
Diagnostic Lab Data: Cat Scan, Eye exam.
CDC Split Type:

Write-up: Headache, dizziness, chills, fever, eye movement, nausea, chest pain, muscle weakness and pain, falls.


VAERS ID: 1377838 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-25
Onset:2021-05-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Gait disturbance, Headache, Hyperhidrosis, Musculoskeletal stiffness, Pain, Pain in extremity, Rash, Rash papular, Rash pruritic, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Vitamin B12 Calcium Women''s one a day
Current Illness:
Preexisting Conditions: Gastric Sleeve Type II Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Five hours after the vaccine I started to get chills. When I got home from work I was shivering and I had body aches and I felt really tired. I could barely walk and I felt stiffness and pain in my legs. I went right to bed and I was sweating. My skin was burning all over and I had headaches. I felt better after 24 hours but I was still a little tired. I started to get a rash which was on my right arm and my left and right chest. I went to clinic. The rash was raised red bumps that were very itchy. It covered my whole right arm. The rash got better after I started to use the Triamcinolone cream. I was given. I still have the rash on my arm and my chest after two weeks but it has improved.


VAERS ID: 1377861 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-05-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Magnetic resonance imaging, Migraine, Pain, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal hayfever
Allergies: None
Diagnostic Lab Data: MRI, ER visit about May 7.
CDC Split Type:

Write-up: 10 day long migraine headache located behind the left eye and left temple. Throbbing, recurrent pain. Accompanied by dizziness and visual changes.


VAERS ID: 1377889 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-07
Onset:2021-06-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Nausea, Retching, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitriptyline 25 mg, Buspirone 10 mg, Emgality 120mg/ml subcutaneous syringe, Emgality pen 120 mg/ml subcutaneous pen injector, EpiPen 2 pak 0.3 mg/0.3 ml injection, Flonase 50mcg/actuation nasal spray, Flovent HFA 110 mcg/actuation aerosol
Current Illness: none
Preexisting Conditions: anxiety, asthma, chronic low back pain, allergic rhinitis, depressive disorder, fibromyalgia, gastroesophageal reflux disease, herpes zoster, hyperlipidemia, hypokalemia, irritable bowel syndrome, obstructive sleep apnea syndrome, panic disorder without agoraphobia, headache
Allergies: Aspirin, bleach, egg, Morphine, Penicillins, shellfish, Venlafaxine HCI, Zofran ODT
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt started feeling nauseous, dizzy, gagging and blurry vision within 5 minutes of administration. Healthcare provider assessed patient and advised ER. Clinic staff escorted patient to the ER.


VAERS ID: 1377911 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-25
Onset:2021-05-25
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: School       Purchased by: ?
Symptoms: Peripheral swelling, Temperature difference of extremities, Ultrasound scan
SMQs:, Cardiac failure (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vimpat, rosuvastatin
Current Illness: N/A
Preexisting Conditions: Partial epilepsy with impairment of consciousness, intractable, History of traumatic brain injury, Hyperlipidemia, History of venous thromboembolism, Presence of IVC filter, Androgen deficiency
Allergies: N/A
Diagnostic Lab Data: U/S of left lower leg on 5/25
CDC Split Type:

Write-up: Patient noticed swelling in lower left leg on 5/18 and called office on 5/25 with swelling and temperature change in left leg, he was sent to the emergency room.


VAERS ID: 1377919 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-08
Onset:2021-05-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20GA21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunoglobulins increased, Loss of consciousness, Lymphocyte count decreased, Neutrophil count increased, Presyncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium, Cymbalta, multi Vitamin,
Current Illness:
Preexisting Conditions: Fibromayalga
Allergies:
Diagnostic Lab Data: very low lymphosyte level and very high Neutrophil level as well as a very high immunoglobin level. I can provide more specific detail upon request.
CDC Split Type:

Write-up: The emergency room said it was a vasovagal event: I felt fine one minute, and passed out and vomited quite a bit out of nowhere. I was at a baby shower and an ambulence had to be called to take me to the emergency room. I was released after blood work was taken and a few test performed again stating that it was only a vasovagal event not related to the vaccine. However, my bloodwork came back the following day and my blood work confirmed that I had a very low lymphosyte level and high Neutrophil level as well as a very high immunoglobin level. My Primary Care physicians office confirmed that the event and blood results must be a reaction to the vaccine.


VAERS ID: 1378010 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-05
Onset:2021-05-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1MG of imodium daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: See above for timeline and treatment.
CDC Split Type:

Write-up: Within 72 hours of receiving the vaccine, I began experiencing itchiness in random locations on my body. However, it was intermittent and not too severe - initially. The itchy rash would pop up and subside, until Weds May 26th. In the middle of that night (5/26) I awoke with the most severe itching and discomfort that I''ve ever experienced, and it was in spots across my arms, legs, abdomen, inner thighs, underarms, soles of feet, wrists, and elsewhere. The next morning (Thursday 5/27) I began calling dermatology offices and clinics hoping to secure a Doctor''s appointment ASAP to get a diagnosis and hopefully some relief. I was able to secure an appointment at Immediate Care for later that morning. At that time I received a steroid shot in my arm, and began a cycle of Prednisone to address the rash. It persisted and was very uncomfortable for the following three days, but thankfully began to subside due to the steroids by Monday 5/31. I would like to stress that I''ve had no known allergies in my life, and that this was the most extreme rash and itching I''ve ever experienced. If I had it to do over again, I would not get the vaccine.


VAERS ID: 1378013 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-06
Onset:2021-06-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 4 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: iodine
Diagnostic Lab Data: ekg, ct scan done 6-6-2021
CDC Split Type:

Write-up: Patient fainted within 5 minutes of receiving vaccine.


VAERS ID: 1378029 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-10
Onset:2021-05-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Heart rate increased, Hypertension, Hypoaesthesia, Magnetic resonance imaging
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: SERVERE REACTIONS TO FLU SHOT
Other Medications: Tylenoyl
Current Illness: no
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Went to the er to get a mri
CDC Split Type: vsafe

Write-up: Started wit a headache numbness in my face difficulties of breathing heart rate was high dizzyniess blood pressure was high numbness on the whole right side of body


VAERS ID: 1378035 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Numbness in both arms and legs.


VAERS ID: 1378082 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-05-30
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

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

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

Write-up: I63.9 - Stroke (cerebrum)


VAERS ID: 1378193 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-05
Onset:2021-04-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal distension, Angina pectoris, Arthralgia, Blood test, Cardiac monitoring, Discomfort, Dizziness, Electrocardiogram, Headache, Pain in extremity, Vision blurred, Visual impairment, X-ray
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Omega3 Chondroitin glucosamine lions mane mushroom zinc vitamin C
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: Iodine Sensitivity opiates Green beans Pollen Allergies
Diagnostic Lab Data: EKG, Xray, heart monitor. Blood tests. They were looking for blood clots.
CDC Split Type: vsafe

Write-up: 04/08/2021- Day of shot, pain began and lasted over 4 weeks, went across my shoulder around my heart and down my arm, pressure, discomfort kind of pain. 04/11/2021 began having extreme dizziness. stabbing pains around hear while driving, lasted for 10 minutes. 05/04/2021 I woke and I had blurry spot in vision, more dominant in left but was in both eyes, then began to spread, last about half an hour, was left with headache, I went to ER. I started to get bloated, I am dealing with a lot of stomach issues. I have to see endocrinologist .


VAERS ID: 1378250 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-03
Onset:2021-06-02
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Cough, Eye disorder, Neurological symptom
SMQs:, Anaphylactic reaction (broad), Corneal disorders (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: coronary artery disease-ongoing but function just fine-just hereditary
Allergies: hydralazine & statins
Diagnostic Lab Data: went to my urgent care on 6/4 and they diagnosed the bells palsey, gave me prednazone and an antibiotics
CDC Split Type:

Write-up: bells palsey - severe issue in left eye and left side; minor chest cough I didn''t have before


VAERS ID: 1378261 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-28
Onset:2021-05-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Laboratory test normal, Magnetic resonance imaging, Muscle spasms, Muscle twitching
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: B12 Calcium Turmeric with probiotic D Multivitamin
Current Illness: None
Preexisting Conditions: Autoimmune
Allergies: None aware of
Diagnostic Lab Data: ER visit 05/30/2021 - blood work normal but referred to neurologist. MRI scheduled 06/13/2021 - awaiting appointment General practitioner as put in a prescription for more blood which will occur this week. ON GOING TESTS AS THIS HAS NOT GONE AWAY AND NO DOCTOR KNOWS WHAT TO DO!!
CDC Split Type:

Write-up: 7pm night of shot and has not gone away Muscle spasms and twitching Elevated heart rate


VAERS ID: 1378313 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-25
Onset:2021-05-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hot flush, Immediate post-injection reaction, Impaired work ability, Injection site cellulitis, Injection site erythema, Injection site induration, Injection site warmth, Neck pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), 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: Blisovi Cymbalta Vitamin D
Current Illness: N/A
Preexisting Conditions: Scoliosis Depression Anxiety
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate reaction, redness on arm, hot to the touch, hard area at site of vaccination; began 5/25/21 5/26 and 5/27 had to take time off work due to fatigue, hot flashes, arm soreness, neck soreness, chills. Symptoms continued and I was seen at Urgent Care on 5/29 where they prescribed an antibiotic and steroid due to cellulitis at the site. 5/30 I began having headaches which have continued non-stop. Hot flashes, chills, and neck soreness have gone away. Fatigue, cellulitis at the site, and arm soreness have continued. I''ve had symptoms for 13 days. I saw my nurse practitioner due to headaches on 6/2 and was told to use heat and tylenol for headaches.


VAERS ID: 1378341 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Blindness unilateral, Computerised tomogram head normal, Computerised tomogram neck, Eye pain, Magnetic resonance imaging head normal, Optic nerve cupping, Retinal artery occlusion, Retinal oedema, Retinal pallor, Scan with contrast normal, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (narrow), Optic nerve disorders (narrow), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Head and Neck with contrast and MRI/MRA were normal. Ophthalmology Physician diagnosed as arterial occlusion of ophthalmic artery despite patent arteries on imaging
CDC Split Type:

Write-up: Patient developed painful blurry vision in left eye that progressed to painless blurry vision in same eye within 24 hours after onset of symptoms. Patient had edematous and pale retina with swollen optic cup. Patient has had complete vision loss in his left eye since.


VAERS ID: 1378410 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-12
Onset:2021-03-25
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperglycaemia, Type 2 diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine, methylphenidate, multi vitamins, vitamin D3, zinc, fish oil, statin,
Current Illness: None
Preexisting Conditions: Taking statin
Allergies: None
Diagnostic Lab Data: Hospital april 1st.
CDC Split Type:

Write-up: New onset type 2 diabetes Hyperglycemia , Now on medications diet daily testing


VAERS ID: 1378436 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Joint range of motion decreased, Muscle spasms, Neck pain, Pain in extremity, X-ray
SMQs:, Dystonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Pineapple
Diagnostic Lab Data: X-Ray
CDC Split Type: vsafe

Write-up: Muscle spasm in the back of the neck Foot pain Left arm pain/unable to use or lift it Pain in the bottom of my foot and neck pain are still ongoing The pain usually occurs around night time


VAERS ID: 1378479 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Aphasia, Arthralgia, Balance disorder, CSF protein increased, Central venous catheterisation, Feeding disorder, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Intensive care, Lumbar puncture abnormal, Magnetic resonance imaging normal, Musculoskeletal disorder, Neck pain, Pain, Pain in extremity, Paraesthesia, Plasmapheresis, Sensory loss, Swelling face, Weight bearing difficulty
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: April 21, 2021 - CT w/Angio and MRI completed - unremarkable April 24, 2021 - Lumbar Puncture showed elevated protein levels in CSF
CDC Split Type:

Write-up: Radiating pain from the right neck, shoulder and arm that spread to the left side. Tingling sensation in fingers, along with pain. Taken to ED, labs and imaging were done that were inconclusive. Tingling and numbness spreading to feet and legs, but however patient was discharged even in worsening condition with no answers, and told to make an appointment with a neurologist the following week. After being brought home, the numbness spread and patient could not support her weight and would lose balance. Ambulance called and taken back to the same facility. Admitted under observation initially, the following day, a lumbar puncture was completed, at the request from our daughter (who is a nurse) to the doctors, that showed elevated protein in the CSF. It was concluded that patient showed clinical signs of Guillian-Barre Syndrome and was subsequently started on IVIG therapy. Her condition worsened and she was upgraded to progressive care and then the neuro ICU when numbness had spread to her face. A central line was placed and patient was started on plasmapheresis. Patient showed loss of feeling and function in her arms and legs, swelling in her face that did not allow her to speak or eat properly. 3 more rounds of IVIG were done after plasmapheresis was completed. Patient was stabilized and transferred to the rehabilitation hospital for rehab and therapy.


VAERS ID: 1378484 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Neurological examination normal, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not reported
Current Illness: Patient had an esophagogastroduodenoscopy on 6/1/2021, one day prior to vaccination. He had open heart surgery on 3/22/2021, and had a pacemaker implanted on 3/29/2021.
Preexisting Conditions: AV BLOCK, COMPLETE PRESENCE OF IMPLANTABLE CARDIAC PACEMAKER CAD W HX OF CABG ATRIAL FLUTTER, PAROXYSMAL HX OF ASCENDING AORTA REPAIR SCREENING FOR COLORECTAL CANCER, HIGH RISK OBESITY, BMI 35-39.9, ADULT ADULT OBSTRUCTIVE SLEEP APNEA FHX OF COLORECTAL CANCER ANEMIA INSOMNIA HX OF AORTIC ROOT REPLACEMENT UPPER GI HEMORRHAGE HX OF PEPTIC ULCER
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient felt fine during observation period after receiving Janssen. On his drive home he experienced blurred vision in his right eye that lasted for about 3 minutes. He returned to vaccine site. Doctor on site was called and patient was transferred to the doctor''s office for further evaluation. No symptoms of anaphylaxis. Neurological exam normal. No other symptoms of stroke. Vital signs stable. Patient feels fine. Due to patient''s cardiac history, doctor was concerned about a possible transient ischemic attack. Therefore, he was transferred to the emergency department for further evaluation. Patient declined additional tests in the ED. Patient admitted to the ED, pt with normal exam. Sx only lasted 2-3 minutes. Consulted with neurologist. Does not sound like stroke. Also not suggestive of known J & J vaccine reaction. Suggest ophth eval.


VAERS ID: 1378503 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-10
Onset:2021-05-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Computerised tomogram abdomen, Computerised tomogram head, Dehydration, Ear discomfort, Ear infection, Ear pain, Echocardiogram, Electrocardiogram normal, Gastrointestinal pain, Headache, Hypotension, Inferior vena cava dilatation, Inflammation, Metabolic function test, Musculoskeletal stiffness, Neck pain, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), Hypokalaemia (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: levothyroxine birth control Hydrochlorothiazide loratadine
Current Illness: None
Preexisting Conditions: Hashimoto''s thyroiditis Idiopathic edema RBBB
Allergies: Codeine Mucinex DM
Diagnostic Lab Data: CT scan of head and abdomen Complete blood and metabolic panel EKG
CDC Split Type:

Write-up: Had typical symptoms within 24 hrs - low grade fever (101F), body aches and arm pain. On second day developed mild headache that went across forehead. On 5/15/21, developed right ear pain - pressure in ear and headaches continued. Intermittently the left ear would also have pain. Started developing stiffness on the right side of neck that accompanied the ear pain. Went to urgent care on 5/20/21. Doctor said both ears were visibly full, especially the right ear. Prescribed Azelastine nasal spray. Called PCP in morning of 5/21/21, and was prescribed prednisone for 5 days to control inflammation. Prednisone worked after a few days but was still run down and pain developed in my abdomen and along the right side of back/leg. Went to ER on 5/24.21. Doctors performed tests for blood clots. Was told I was weak and dehydrated and given IV and pain meds. Was negative for blood clots but my IVC was dilated. Pains persisted for about 2 weeks - especially in the right abdomen. Went to cardiologist on 6/4/21 and had a normal EKG but low BP. Doctor believes abdominal pain is gastrointestinal and put me on proton pump inhibitor. I am getting echocardiogram on 6/10./21 to check IVC. Since then most pains have subsided except weak, right sided abdominal pain. The right ear pain is back. Starts in the morning with outer cartilage of ear getting inflamed, followed by pressure/pain in right ear, then pain in right neck. Has been going on for a month now. 100% related to vaccine - came after vaccination and never had before.


VAERS ID: 1378568 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-11
Onset:2021-05-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Disorientation, Electrocardiogram normal, Headache, Hyperhidrosis, Injection site rash, Magnetic resonance imaging normal, Pyrexia, Rash, Rash vesicular, Vertigo
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Rash and streaking/banding to small pox vaccine. unknown manufacturer, 26 years old
Other Medications: None
Current Illness: None
Preexisting Conditions: back and knee pain
Allergies: None
Diagnostic Lab Data: on May 14th EKG and MRI completed and came back clear at hospital
CDC Split Type:

Write-up: Was fine at the time and shortly after the injection. Woke up the next morning to a 103 degree fever, chills, sweating, disorientation, headache, vertigo. several days later developed a "shingles-like" rash around the injection site which is now radiating down the arm and back of shoulder. Rash is only in that area and no where else on the body. no previous history with vertigo or shingles rashes


VAERS ID: 1379003 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blepharospasm, Computerised tomogram normal, Headache, Magnetic resonance imaging normal, Trigeminal nerve injection
SMQs:, Dystonia (broad), Periorbital and eyelid disorders (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pain medication
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Ct scan and mri supposedly come out normal but headache has not gone away since getting vaccine.
CDC Split Type:

Write-up: Extreme headache on left side of head, accompanied by eye twitching. Headache started a few days after getting vaccine and hasn?t gone away sense than. Went to doctor and got a ct scan and mri but couldn?t find anything. Even got three injections on left nerve on head and the pain did not dissipate. Pain medication only dulls pain once in awhile. Most of the time pain medication has not effect. I?ve had this pain for months and it?s not a coincidence that it started after getting the vaccine.


VAERS ID: 1379021 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-06-07
Onset:2021-06-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

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

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

Write-up: Patient was severly dizziness and took it upon himself to lay down on the floor. He was also experiencing nausea, sweating on his head, and fast heartbeat which was conveyed to the EMT. He also requested an ambulance.


VAERS ID: 1379027 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-05-13
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 01A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram
SMQs:, Hearing impairment (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: Centrum vitamin; ditropan; Albee;Aspirin;Atorvastatin; Metformin; Propranolol; Rizatriptan; Tramadol.
Current Illness: Diabetic 2 and thyroid
Preexisting Conditions: Back issues; diabetes, thyroid
Allergies: Penicillin; msg; contrast dye.
Diagnostic Lab Data: Ct scan during visit to Ed
CDC Split Type:

Write-up: Bell Palsy


VAERS ID: 1379301 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816027 / 1 LA / IM

Administered by: Pharmacy       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: Patient said that she has experienced pain in her arm since receiving the shot.


VAERS ID: 1380630 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood chloride, Blood lactate dehydrogenase, Cerebrovascular accident, Chest discomfort, Choking, Computerised tomogram, Dehydration, Haematemesis, Malaise, Nervousness, Pruritus, Spinal pain
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal haemorrhage (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PRAVASTATIN; ASA
Current Illness: Breast cancer (Patient is two time breast cancer survivor. Patient is on cancer drug for 5 year.); Non-smoker; Sulfonamide allergy (CAUSE NIGHT TIME SWELLS IN MOUTH AND TONGUE)
Preexisting Conditions: Medical History/Concurrent Conditions: Chemotherapy; Hiatal hernia; Intervertebral disc annular tear; Radiation therapy; Stroke; Vertebral artery dissection
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Lactate dehydrogenase; Result Unstructured Data: 2.5 (unit not reported); Test Date: 2021; Test Name: Chloride; Result Unstructured Data: 110 (unit not reported); Test Date: 2021; Test Name: Lactate dehydrogenase; Result Unstructured Data: 1.5 (unit not reported); Test Date: 20210428; Test Name: CT scan; Result Unstructured Data: showed a same occlusion; Test Date: 20210428; Test Name: CT scan; Result Unstructured Data: Occluded Right Vertebral Artery; Test Date: 20210515; Test Name: CT scan; Result Unstructured Data: showed an occluded right vertebral artery; Comments: occluded right vertebral artery and 70% stenosis of right carotid artery
CDC Split Type: USJNJFOC20210602437

Write-up: THROWING UP BLOOD; FEELING LIKE BEING CHOKED; HEAVY FEELING IN CHEST; FELT SHAKY; FELT SICK; STROKE-LIKE SYMPTOMS; PAIN IN BASE OF SPINE; LEFT TORSO AND BOTH ARMS ITCHING; DEHYDRATION; This spontaneous report received from a patient concerned a 58 year old female. Initial information was processed along with additional information on 04-JUN-2021. The patient''s height, and weight were not reported. The patient''s past medical history included vertebral dissection of right vertebral artery in 2000, hiatal hernia, chemotherapy, radiation, vertebral tear, 5 years of cancer drugs and stroke-like symptoms, and concurrent conditions included 2 times breast cancer survivor, non-smoker, and sulfa drug allergy cause night time swells in mouth and tongue. The patient experienced pain in base of spine when treated with pegfilgrastim for breast cancer. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A expiry: UNKNOWN) dose was not reported, 1 in total administered at left arm on 09-APR-2021 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid, and pravastatin. On an unspecified date in 2021, the patient had elevated lactate level of 2.5 (unit unspecified) and was 1.5 (unit unspecified) on repeat and also had elevated chloride level was 110 (unit unspecified). The patient was dehydrated. On 09-APR-2021, the patient had left torso and both arms itching for 4 hours, started within half hour after received vaccine. On 10-APR-2021, the patient experienced pain in base of spine, which was exactly the same as when she received Neulasta during a previous cancer treatment regimen and patient experienced headache for 3 days. On 21-APR-2021, the patient woke up with left side numbness from head to toes, feeling like being choked as if like an allergy, felt heaviness in chest, within one hour patient felt shaky and like she was going to faint, felt dizziness/lightheaded and laid down for 2 days, later felt like her eyes were going to pop out of her head, was putting Refresh eye drops in her eyes and was having problems focusing her eyes (vision disturbances). The patient was only able to stay up for 2 hours, then had lie down because felt sick and weakness and had sever fatigue. All like stroke-like symptoms. The symptoms started on 21-APR-2021. The patient went to emergency room on 24-APR-2021 and discharged on same day. On 28-APR-2021, the patient had computed tomography scan and showed occluded right Vertebral artery. The patient had a computed tomography scan one year ago and there was no occlusion. They did a computed tomography scan that showed a same occlusion as on 28-APR-2021. On 28-APR-2021, the patient had stenosis of right carotid artery. The patient went back to emergency room on 15-MAY-2021 because she was throwing up blood and dizzy and she was told to go to emergency room. On 11-JUN-2021, she was going to see a stroke neurologist specialist a neurosurgeon 16-JUN-2021. On 15-MAY-2021, the patient went to emergency room and they re-performed a computed tomography scan and it showed an occluded right vertebral artery just as first scan did. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from left torso and both arms itching on 09-APR-2021, had not recovered from pain in base of spine, and stroke-like symptoms, and the outcome of heavy feeling in chest, feeling like being choked, felt shaky, felt sick, dehydration and throwing up blood was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: This spontaneous report received from a patient concerned a 58-year-old female who experienced stroke-like symptoms and occluded vertebral artery 15 days after vaccine. Past medical history included vertebral dissection of right vertebral artery in 2000, hiatal hernia, chemotherapy, radiation, vertebral tear, 5 years of cancer drugs and stroke-like symptoms, and concurrent conditions included 2 times breast cancer survivor. Concomitant medications included acetylsalicylic acid, and pravastatin. On day 12 after vaccine, the patient woke up with left side stroke-like symptoms. The patient went to emergency room on day 15 and discharged on same day. On day 19, the patient had computed tomography scan and showed occluded right Vertebral artery. The patient had a computed tomography scan one year ago and there was no occlusion. She was discharged and evaluated by stroke neurologist. There is no report of thrombocytopenia to suggest thrombosis with thrombocytopenia syndrome. Given the pre-existing history of vertebral artery dissection, there is a plausible alternative explanation for the event.


VAERS ID: 1380658 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LOT: 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Gait disturbance, Gait inability, Myalgia, Pain in extremity, Pulmonary thrombosis, Thrombosis, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210420; Test Name: Ultrasound scan; Result Unstructured Data: found a blood clot in the right leg and left lung
CDC Split Type: USJNJFOC20210607546

Write-up: BLOOD CLOT IN RIGHT CALF; BLOOD CLOT IN LEFT LUNG; COULDN''T WALK; FATIGUED WHEN WALKING; MUSCLE PAIN; WALKING SLOW / STUMBLING; LEFT CALF PAIN; This spontaneous report received from a consumer concerned a 40-year-old female of unknown race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number:1808980 00040604, expiry: not reported) dose was not reported,1 total, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. In APR-2021, about a week after vaccination, the patient experienced right calf pain/right lower leg pain and muscle pain. Patient was unable to walk, experienced fatigue while walking and was out of breath/unable to breath and on 20-APR-2021, the patient went to the urgent care (Emergency room) and then to the hospital. At hospital, patient had done Ultrasound Test and found blood clot in right calf (right leg) and in left lung. Patient was unable to breath. At hospital, patient was given with medication for blood clotting. After taking medication, patient was able to take breath. On 21-APR-2021, patient was discharged from hospital with medication to prevent blood clotting. Patient was hospitalized for 2 days. Patient was taking the medication one each in morning and evening. On 02-JUN-2021, patient was still walking slowly, tumbling and was not able to walk. On same day, patient also had a pain in left calf and fatigued. On 03-JUN-2021, patient went to the Emergency room(ER). Laboratory data included: Ultrasound scan (NR: not provided) which showed a blood clot in the right leg and left lung. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fatigued when walking, had not recovered from couldn''t walk and left calf pain, and the outcome of walking slow / stumbling, muscle pain, blood clot in right calf and blood clot in left lung was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210607546-covid-19 vaccine ad26.cov2.s -Blood clot in right calf, Blood clot in left lung, Couldn''t walk. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210607546-covid-19 vaccine ad26.cov2.s -Fatigue when walking, muscle pain. This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1380661 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Rash, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hard of hearing (Patient wears hearing aids.)
Preexisting Conditions: Comments: Patient had no comorbidities condition. Patient was not overweight and was very healthy.
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: Diagnostic ultrasound; Result Unstructured Data: DVT was diagnosed
CDC Split Type: USJNJFOC20210607591

Write-up: DEEP VEIN THROMBOSIS; RED SPOTS ON RIGHT LEG; This spontaneous report received from a consumer concerned a 66-year-old white and Non-Hispanic or Latino male. The patient''s height and weight were not reported. The patient''s concurrent conditions included hard of hearing, and other pre-existing medical conditions included, patient had no comorbidities condition, was not overweight and was very healthy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A and expiry: UNKNOWN) dose was not reported, 1 total dose administered on 22-MAY-2021 in left arm for prophylactic vaccination. No concomitant medications were reported. On an unspecified date in 2021, about 5 days later after vaccination, patient started getting red spots on both legs, but the spots on the right leg went away later it became worse next day. On an unspecified date, patient experienced the pain which became bad and when reporter looked at it she thought it was cellulitis because it was hot, red and swollen. The Patient had swelling from the knee down and experienced lot of pain in his knee. The patient was sent to outpatient clinic where the ultrasound was done on 02-JUN-2021 and DVT (Deep vein thrombosis) was diagnosed. The blood clot was behind the knee of patient. The patient visited the emergency room but since he had no comorbidities condition he was not admitted and was sent home with medication. The patient was given Eliquis as a treatment drug for the event. The reporter mentioned that the medication was expensive, and the patient was on Medicare and there were programs to help with it. The reporter mentioned that medication can put the patient at risk of kidney failure. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from red spots on right leg on 2021 and had not recovered from Deep vein thrombosis. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210607591- JANSSEN COVID-19 VACCINE Ad26.COV2.S- Deep Vein thrombosis- This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1380689 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-28
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Flushing, Hypertension, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Allergic reaction to antibiotics (Erythromycin caused rash on torso.); Blood pressure high (. Blood Pressure had usually been 120/60 mmHg); Generalized anxiety disorder (GAD due to work stress); Non-smoker; Penicillin allergy (Penicillin caused rash on torso.)
Preexisting Conditions: Comments: The patient had no known drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 202012; Test Name: Blood pressure; Result Unstructured Data: 120/60 mmHg; Test Date: 2021; Test Name: Blood pressure; Result Unstructured Data: 140/60 to 165/70 mmHg; Test Date: 2021; Test Name: Blood pressure; Result Unstructured Data: 170/70 mmHg; Test Date: 20210429; Test Name: Blood pressure; Result Unstructured Data: 182/81 mmHg; Test Date: 20210429; Test Name: Blood pressure; Result Unstructured Data: 160/60 mmHg
CDC Split Type: USJNJFOC20210611882

Write-up: FLUSHING ON SIDE FACE AND UPPER THIGH; POUNDING HEART; ELEVATED BLOOD PRESSURE; This spontaneous report received from a patient concerned a 68 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included generalized anxiety disorder (gad), high blood pressure, non-smoker, non-alcoholic, penicillin allergy, and erythromycin allergy, and other pre-existing medical conditions included the patient had no known drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 23-JUN-2021) dose was not reported, administered on 28-APR-2021 11:00 for prophylactic vaccination. No concomitant medications were reported. On DEC-2020, Laboratory data included: Blood pressure (NR: not provided) 120/60 mmHg. On 2021, Laboratory data included: Blood pressure (NR: not provided) 140/60 to 165/70 mmHg, 170/70 mmHg. Treatment medications included: metoprolol. On 28-APR-2021, the subject experienced flushing on side face and upper thigh. On 28-APR-2021, the subject experienced pounding heart. On 28-APR-2021, the subject experienced elevated blood pressure. On 29-APR-2021, Laboratory data included: Blood pressure (NR: not provided) 182/81 mmHg, 160/60 mmHg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flushing on side face and upper thigh, and pounding heart on 28-APR-2021, and had not recovered from elevated blood pressure. This report was non-serious.


VAERS ID: 1381356 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Wyoming  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Generalised tonic-clonic seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Bipolar disorder; Borderline personality; Cigarette smoker; Marijuana use; Memory loss
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure dropped (Medication causes her to drop her blood pressure which resulted to seizure.); Pulse decreased (Medication causes her to drop pulse which resulted to seizure.); Seizures; Comments: Patient had no known allergies. The patient did not have any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210611850

Write-up: GRAND MAL SEIZURE; This spontaneous report received from a parent concerned a patient of 19-year-old female. The patient''s weight was 210 pounds, and height was 170 centimeters. The patient''s past medical history included seizures, drop blood pressure, and pulse drop, and concurrent conditions included borderline personality, bipolar disorder, cigarette smoker, non-alcohol user, marijuana user, and memory loss, and other pre-existing medical conditions included patient had no known allergies. The patient had no drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: UNKNOWN) dose was not reported, 1 total administered on 03-JUN-2021 to right deltoid for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, at 7 pm the patient complained of being very tired, she felt that she was passing out and nauseated. At 3 am in morning (04-JUN-2021), patient started to have a grand mal seizure, lied on the floor, totally confused, her eyes went all over the place, she did not remember all the people around her. Based on description patient had memory loss, she could not remember the last 3 years of her life and she was on year between 2017 and 2018. Patient had a history of seizure last 2017 when she was on a psychotropic medication (Topamax) which she was taking because of her bipolar disorder. Medication which was taken for bipolar disorder causes her to drop her blood pressure and pulse which resulted to seizure. Patient was planning to visit doctor. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from grand mal seizure. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210611850-COVID-19 VACCINE AD26.COV2.S-Grandmal seizure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE


VAERS ID: 1381677 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-06-08
Onset:2021-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18211288 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
SMQs:

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

Write-up: 5 minutes after shot was given and patient sat down to be monitored patient complained of not feeling well. Called 911 and ambulance was sent. Patient went with them to the hospital. Patient never loss concious or needed extra care. Monitored and gave water (all she wanted).


VAERS ID: 1381680 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-03-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia
SMQs:, Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: J12.82 - Pneumonia due to Coronavirus disease 2019 U07.1 - COVID-19


VAERS ID: 1381712 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-06-03
Onset:2021-06-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 04A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Feeling abnormal
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: 5 days after vaccine started "feeling off" and was experiencing chest pain and difficulty breathing.


VAERS ID: 1381727 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-20
Onset:2021-05-31
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Magnetic resonance imaging, Venogram
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sumatriptan, Excedrin Migraine
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data: MRI and MRA Venogram
CDC Split Type:

Write-up: Severe headache for 1 week. Took OTC medications and Prescription medications with no effect


VAERS ID: 1381756 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-06-08
Onset:2021-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Eye colour change, Fall, Hyporesponsive to stimuli
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Client was vaccinated at 14:02 with Janssen vaccine and was then going to be observed for 15 minutes. Client requested to be observed in the lobby waiting area instead of in the exam room. Client walked himself to the chair, sat down and began to type on his phone. About 8 minutes into his observation, client began to fall forward and did not appear as responsive. Staff immediately tended to client and spoke to client requesting a response. Minimal response was given. 911 was called and responded within 2 minutes. Client was clammy, cool to the touch and eyes appeared glossy and dark. Client''s blood pressure was 70/50 at 14:12. Med then arrived and BP was 53/35. At 14:20 (first BP taken when med arrived). Client became responsive but blood pressure minimally improved. Client was taken to the hospital and in agreement.


VAERS ID: 1381829 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-08
Onset:2021-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: On 6/8/21, patient received Johnson & Johnson vaccine. He sat for 5 minutes in the consultation room waiting for friend to get vaccinated. When he and his friend walked out of the room, patient stated that he was going to pass out. She thought he was joking, and then he collapsed and hit his head against the corner of the pharmacy counter. He was then conscious and was aware of his surroundings, but he was injured from the impact, and bled. Paramedics arrived, wrapped his head and released him. He and a friend will go to the ER for follow-up, and he was able to walk out without assistance.


VAERS ID: 1381860 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Aphasia, Chest X-ray abnormal, Computerised tomogram abnormal, Eye movement disorder, Feeding disorder, Hydrocephalus, Influenza like illness, Jaw disorder, Mental status changes, Pulmonary oedema, Unresponsive to stimuli, Urinary tract infection, Urine analysis abnormal
SMQs:, Cardiac failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol Phenobarbital Clonozepam Diazepam Soma
Current Illness: Epilepsy
Preexisting Conditions: Epilepsy Cerebral Palsy
Allergies: Penicillin
Diagnostic Lab Data: CT scan- hydrocephalus. Chest x-ray -small amount of fluid on one side of lung. Urinalysis -UTI Admitted to Hospital
CDC Split Type:

Write-up: Quick onset of flu like symptoms, progressed to altered mental state, unable to close her eyes. Unable to eat or drink. Her face was frozen with her open eyes fixed to the top of her head, jaw dropped. Unresponsive, unable to verbalize. I have cared for her over 15 years and have never seen anything like this . ER visit.


VAERS ID: 1381909 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-06-01
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine (5 mg) Carvedilol (3.125 mg) Rosvustatin (5 mg) Baby Aspirin
Current Illness: Heart disease, sleep apnea, hypertension
Preexisting Conditions: N/A
Allergies: None
Diagnostic Lab Data: Visual inspection
CDC Split Type:

Write-up: Shingles developed on my left lower back and torso approximately three month after receiving the Covid-19 vaccine.


VAERS ID: 1382017 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZIA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Myalgia, Pain in extremity, Pyrexia, Ultrasound scan normal, X-ray limb
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabupentin, Bystolic, Rosuvastatin
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Ultra Sound and xray of right let. 6/3
CDC Split Type:

Write-up: Severe chills and fever and sweating started at 7pm and continued until around 6am. Severe pain in right calf muscle started at 3am on 6/3 and lasted for 24 hours. At the direction of my dr, i was seen in the ER at hospital. The hospital checked for blood clot but ultra sound showed no clots.


VAERS ID: 1382044 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-06
Onset:2021-06-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: c/o throat tightness after vaccination. No SOB, rash, hives, headache, altered mental status. pt. remain vocal and swallows water with no difficulty. no PMH reported. Allergy to bactrim and pollen. Takes Zyrtec PRN. Assessment WNL. V/S BP 134/72, P62, R 18, O2Sat 98%. Pt. after few mins insisted throat is closing up. Emergency personnel is called to the scene. Epipen is given at 1:28pm. Ambulance called with pt. transported at 1:39pm to hospital for further evaluation. Patient not in distress prior to being transported.


VAERS ID: 1382276 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chest X-ray normal, Electrocardiogram normal, Heart rate increased, Laboratory test normal, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Arthritis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topimax
Current Illness: None
Preexisting Conditions: Epilepsy
Allergies: Amoxillian and Penicillian
Diagnostic Lab Data: EKG, chest xray, and lab work all completed due to my symptoms. All results came back normal and the ED physician stated the high pulse was connected to the vaccine.
CDC Split Type:

Write-up: I woke up with severe pain in my neck and across my shoulder blades(upper back.) Not long after this, my Fit bit signaled a prolonged period of high pulse. My resting heart rate peaked over 135 and stayed about 110 for 6 hours.


VAERS ID: 1382345 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Food allergy, Pain in extremity, Rash macular
SMQs:, Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I felt pain in my right arm (the opposite arm of the vaccine). And my legs and hands hurt with a lot of fatigue; the next day I ate peanuts and peanuts gave me allergy with red spots all over my body. Three days after, I ate peanuts again and it was the same. On May 15, 2021 I went to the Emergency room at Hospital, and was I treated only for my continuing arm pain. I was given Cyclovenzaprine10 MG daily. I have not recover of these reactions and I continue taking the pills.


VAERS ID: 1382451 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aspiration, Balance disorder, Blood test, Computerised tomogram normal, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, Neurological symptom, SARS-CoV-2 antibody test positive
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Probiotics, Vitamins & Zertek
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Scan, MRi BraIn & neck and many blood tests
CDC Split Type:

Write-up: The day after shot Covid like symptoms. The nest morning Stroke like symptoms required hospitalization for two weeks. I was wobbly and could not drink water without asperating. Symptoms still persist today..Extensive testing showed no stroke occured. Prior to shot, I was tested for antibodies from a Covid infection 7 months ago. The antibodies where still very strong. I gave in to peer pressure and got the shot with my doctors approval.


VAERS ID: 1382570 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-03-13
Onset:2021-03-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal distension, Angiogram pulmonary abnormal, Atelectasis, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Dyspnoea, Oesophageal disorder, Pericardial effusion, Pleural effusion, Pulmonary oedema, Sleep disorder, Suffocation feeling
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole
Current Illness: None.
Preexisting Conditions: None.
Allergies: N/A
Diagnostic Lab Data: All medical test were performed at Hospital. *CT Angio Chest w/Con and the Impression: 1.) Congestive heart failure with small right pleural effusion. Small pericardial effusion. 2.) No pulmonary artery embolus or aortic dissection. 3.) Gaseous distention of the esophagus. *XR Chest 1 View with Findings: Moderate cardiomegaly with interstitial edema. Aortic contours are normal. Right basilar subsegmental atelectasis. No consolidation or suspicious nodule/mass. No pleural effusion or pneumothorax. Congestive heart failure.
CDC Split Type:

Write-up: Difficulty breathing, shortness of breath. Felt like I was drowning at night when I was sleep.


VAERS ID: 1382691 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-19
Onset:2021-03-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood test, Breast pain, Chest pain, Chills, Computerised tomogram, Echocardiogram, Electrocardiogram, Pain, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (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: I have an IED.
Current Illness: No.
Preexisting Conditions: No.
Allergies: No.
Diagnostic Lab Data: Blood work CT scans EKG X-ray urine test Echocardiogram July 1st, 2021
CDC Split Type: vsafe

Write-up: The night of vaccination I had fever, aches and body chills that lasted for 4 days. On the 6th day after the vaccine the chest pains started. I''ve been seen in the ER three times now. A stabbing pain under my left breast that is continuous.


VAERS ID: 1382954 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808882 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chills, Dizziness, Eye pain, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: High blood pressure
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: Blood clot test, and Radiologic chest exam 4/13/21 at hospital. VNG and audio gram ENT 5/17/21 VHIT & VEMP scheduled for 6/15/21 at ENT. Neurology scheduled for September 2021
CDC Split Type:

Write-up: Had fever chills head ache a dizziness start evening after shot. Fever chills only lasted 2 days. Dizziness nausea pain behind left eye continues to get worse. Still seeing doctors and going through testing


VAERS ID: 1383640 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-02
Onset:2021-06-06
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Anal incontinence, Blood test, Chest X-ray, Computerised tomogram, Fall, Fatigue, Hypotension, Respiratory symptom, Thrombosis, Ultrasound Doppler abnormal, Urinary incontinence, Urinary tract infection, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (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:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan, ultrasound, chest xray, blood work, while in hospital
CDC Split Type:

Write-up: Shortly after vaccine, upper respiratory issue started. Fatigue, falling, soiling bed sheets and pants regularly. Then went to hospital on june 7th with abdominal pain. Low bloid pressure and hight white blood count. Had blood clot. Urinary Infection Possible sepsis. Still in hospital.


VAERS ID: 1383796 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), 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: None
Current Illness: None
Preexisting Conditions: Acid reflux
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Left arm swollen and red and in pain the size of a softball for 5+ days


VAERS ID: 1384282 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Anxiety, Asthenia, Blood test, Computerised tomogram, Dehydration, Depression, Diarrhoea, Electrocardiogram, Feeling abnormal, Frustration tolerance decreased, Influenza like illness, Pain assessment
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Diabetes; Grass allergy; Non-smoker; Thyroid disorder
Preexisting Conditions: Comments: The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: EKG; Result Unstructured Data: clear; Test Date: 2021; Test Name: Pain scale; Result Unstructured Data: 9; Test Date: 2021; Test Name: Blood test; Result Unstructured Data: clear; Test Date: 2021; Test Name: CT scan; Result Unstructured Data: clear; Comments: clear- weakness with uncertain cause, anxiety reaction
CDC Split Type: USJNJFOC20210604777

Write-up: FLU LIKE SYMPTOMS; EPISODES OF DIARRHEA EVERY 1 WEEK; WEAKNESS WITH UNCERTAIN CAUSE; ABDOMINAL PAIN; ABDOMINAL BLOATING; ANXIETY REACTION; DEPRESSION; FEELS LIKE DYING/FEELS LIKE SHIT INSIDE; POSSIBLE DEHYDRATION; VERY FRUSTRATED; This spontaneous report received from a patient concerned a 68 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes, thyroid disease, all grass allergy, trees allergy, non alcohol user, and non smoker. The patient had no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination into left arm. The batch number was not reported and has been requested. The patient was under 6 to 7 other medications which are not related to these symptoms. On 07-APR-2021, the patient had begun experiencing diarrhea which lasted approximately a couple of days and then it went away, and the patient had begun feeling fatigued, weakness with uncertain cause, nausea. Every once a week the patient had claimed having a diarrhea episode. In Apr-2021. the patient had abdominal pain, abdominal bloating and it has been consistent. The patient rates abdominal pain a 9/10 on a scale of 1-10, 10 being the worst. The patient felt like these are flu like symptoms. The patient had about 7-8 emergency room (ER) visits because of these symptoms. The patient does not remember the exact dates. In 2021, the patient stated he felt like shit inside, developed depression, possible dehydration, felt like dying, anxiety reaction and very frustrated. On an unspecified date, the patient was hospitalized for diarrhea, abdominal pain, abdominal bloating, weakness for uncertain cause, fatigue and nausea. The patient narrated he has hospital records. The patient was prescribed with an unspecified anti-emetic medication and it has not been effective. The patient had a planned follow up with his primary health care professional (HCP) on 06-JUN-2021. The patient was even looking into palliative hospice care might be into a mental health ward. The patient was very concerned that his symptoms have now lasted approximately two months. The patient stated they took his vitals, electrocardiogram (EKG), computerized tomogram (CT) scan and did testing on him and they could not find nothing wrong with him and they cleared him. The patient had stated that a rehab nurse would be coming out to his house to do some blood work, a physical on him. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from abdominal pain, abdominal bloating, weakness with uncertain cause, flu like symptoms, episodes of diarrhea every 1 week, depression, anxiety reaction, feels like dying/feels like shit inside, possible dehydration, and very frustrated. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210604777-covid-19 vaccine ad26.cov2.s-abdominal pain, abdominal bloating, flu like symptoms, episodes of diarrhea every 1 week. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). V0: 20210604777-covid-19 vaccine ad26.cov2.s-weakness with uncertain cause. This event(s) is labeled per and is therefore considered potentially related.


VAERS ID: 1384333 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-06
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eye pain, Headache
SMQs:, Glaucoma (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210613084

Write-up: EYE PAIN; SEVERE HEADACHE; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 05-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 06-JUN-2021, the subject experienced eye pain. On 06-JUN-2021, the subject experienced severe headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe headache, and eye pain. This report was non-serious.


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=52&PERPAGE=100&VAX=COVID19&VAXMAN=JANSSEN&ER_ED_VISIT=Yes

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166