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

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



Case Details

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VAERS ID: 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.


VAERS ID: 1384847 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-03-08
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hyperhidrosis, Hypotension, Syncope, Tachycardia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612583

Write-up: COLLAPSED; TACHYCARDIC; HYPOTENSIVE; DIAPHORETIC; This spontaneous report received from a patient concerned a patient of unspecified age, sex, race and ethnic origin. 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: unknown) dose was not reported, 1 total administered on 08-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 08-MAR-2021, 6 minutes after vaccination, patient became tachycardic, hypotensive, diaphoretic and collapsed. Patient attended signature emergency room for clinical review and was later discharged that day. Patient stated, due to unexpected visit to emergency room, was unable to work and missed clinical shift due to illness. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the tachycardic, hypotensive, diaphoretic and collapsed was not reported. This report was serious (Other Medically Important Condition); Sender''s Comments: V0. 20210612583-Covid-19 vaccine ad26.cov2.s -collapsed. 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: 1384848 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Contusion, Dizziness, Headache, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies and did not had drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210510; Test Name: Diagnostic ultrasound; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210613955

Write-up: BRUISING ON BACK OF LEFT KNEE; SEVERE PAIN ON LEFT LEG BEHIND KNEE; HEADACHE; DIZZINESS; This spontaneous report received from a patient concerned a 62 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included no alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no known allergies and did not had drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 203A21A, expiry: Unknown) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced dizziness. On 13-APR-2021, the subject experienced headache. On 26-APR-2021, the subject experienced bruising on back of left knee. On 26-APR-2021, the subject experienced severe pain on left leg behind knee. On 10-MAY-2021, Laboratory data included: Diagnostic ultrasound (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dizziness, and headache on 20-APR-2021, and had not recovered from severe pain on left leg behind knee, and bruising on back of left knee. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1384865 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-25
Onset:2021-05-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Site: Pain at Injection Site-Mild, Systemic: Fever-Medium, Systemic: neck pain-Medium


VAERS ID: 1384934 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-05
Onset:2021-06-02
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0424A1A / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Electrocardiogram normal, Fatigue, Feeling abnormal, Magnetic resonance imaging normal, Urine analysis normal, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal 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: Clariton
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT, EKG, bloodwork 6/5/21 MRI, blood, urine 6/6/21 ENT visit 6/7/21 All test negative
CDC Split Type:

Write-up: Brain fog, vision issues, fatigue/still ongoing. Began 6/2/21


VAERS ID: 1385016 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SC

Administered by: Unknown       Purchased by: ?
Symptoms: ADAMTS13 activity assay, Albumin urine, Blood folate, Blood follicle stimulating hormone, Blood glucose, Blood iron, Blood lactate dehydrogenase, Blood magnesium, Blood phosphorus, Blood thyroid stimulating hormone, Calcium ionised, Contusion, Coombs direct test, Culture urine, Electrocardiogram, Full blood count, Gastrointestinal pathogen panel, Haptoglobin, Hepatitis viral test, ISTH score for disseminated intravascular coagulation, Immunoglobulins, Laboratory test, Malaise, Metabolic function test, Microangiopathic haemolytic anaemia, Plasmapheresis, Protein total, Reticulocyte count, Thrombocytopenia, Thrombotic thrombocytopenic purpura, Troponin I, Urine analysis, Vitamin B12
SMQs:, Haemolytic disorders (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, arterial (narrow), Accidents and injuries (narrow), Renovascular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Lab COMPREHENSIVE METABOLIC PANEL Jun 3, 2021 Lab LDH MD Jun 3, 2021 Lab RETICULOCYTES MD Jun 3, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL MD Jun 3, 2021 Lab MANUAL DIFFERENTIAL MD Jun 3, 2021 Lab ALBUMIN, URINE MD May 24, 2021 Lab COMPREHENSIVE METABOLIC PANEL MD May 24, 2021 Lab LDH MD May 24, 2021 Lab RETICULOCYTES MD May 24, 2021 Lab ADAMTS13 ACTIVITY MD May 24, 2021 Lab TSH, 3RD GENERATION MD May 24, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL MD May 24, 2021 Lab POCT GLUCOSE MD May 24, 2021 Lab COMPREHENSIVE METABOLIC PANEL MD May 17, 2021 Lab LDH MD May 17, 2021 Lab RETICULOCYTES MD May 17, 2021 Lab ADAMTS13 ACTIVITY MD May 17, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL MD May 17, 2021 Lab COMPREHENSIVE METABOLIC PANEL MD May 10, 2021 Lab LDH MD May 10, 2021 Lab RETICULOCYTES MD May 10, 2021 Lab ADAMTS13 ACTIVITY MD May 10, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL MD May 10, 2021 Lab COMPREHENSIVE METABOLIC PANEL MD May 3, 2021 Lab LDH MD May 3, 2021 Lab RETICULOCYTES MD May 3, 2021 Lab ADAMTS13 ACTIVITY MD May 3, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL MD May 3, 2021 Lab RETICULOCYTES MD Apr 28, 2021 Lab LDH MD Apr 28, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL MD Apr 28, 2021 Lab COMPREHENSIVE METABOLIC PANEL MD Apr 28, 2021 Lab ADAMTS13 ACTIVITY MD Apr 27, 2021 Lab RETICULOCYTES DO Apr 27, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 27, 2021 Lab RETICULOCYTES DO Apr 26, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 26, 2021 Lab RETICULOCYTES DO Apr 25, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 25, 2021 Lab RETICULOCYTES DO Apr 24, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 24, 2021 Lab CBC DO Apr 23, 2021 Imaging EKG - PERFORMED BY EKG TECH DO Apr 23, 2021 Lab GASTROINTESTINAL PATHOGEN PANEL DO Apr 22, 2021 Lab TRANSFUSION REACTION-PART 1 DO Apr 22, 2021 Lab ADAMTS13 ACTIVITY POST PHERESIS DO Apr 22, 2021 Lab IONIZED CALCIUM DO Apr 22, 2021 Lab IONIZED CALCIUM DO Apr 22, 2021 Lab LDH DO Apr 22, 2021 Lab TROPONIN I DO Apr 22, 2021 Lab S-100B PROTEIN, SERUM (SENDOUT) DO Apr 22, 2021 Lab IONIZED CALCIUM DO Apr 22, 2021 Lab ADAMTS13 ACTIVITY DO Apr 22, 2021 Lab COMPREHENSIVE METABOLIC PANEL DO Apr 22, 2021 Lab MAGNESIUM DO Apr 22, 2021 Lab PHOSPHORUS DO Apr 22, 2021 Lab RETICULOCYTES DO Apr 22, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 22, 2021 Lab IONIZED CALCIUM DO Apr 21, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 21, 2021 Lab IONIZED CALCIUM DO Apr 21, 2021 Lab IONIZED CALCIUM DO Apr 21, 2021 Lab LDH DO Apr 21, 2021 Lab S-100B PROTEIN, SERUM (SENDOUT) DO Apr 21, 2021 Lab TROPONIN I DO Apr 21, 2021 Imaging EKG - PERFORMED BY EKG TECH MD Apr 21, 2021 Lab MAGNESIUM DO Apr 21, 2021 Lab PHOSPHORUS DO Apr 21, 2021 Lab COMPREHENSIVE METABOLIC PANEL DO Apr 21, 2021 Lab RETICULOCYTES DO Apr 21, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 21, 2021 Lab LDH DO Apr 21, 2021 Lab TROPONIN I MD Apr 21, 2021 Lab TROPONIN I MD Apr 20, 2021 Lab URINE CULTURE DO Apr 20, 2021 Lab URINALYSIS WITH MICROSCOPIC DO Apr 20, 2021 Lab ADAMTS13 ACTIVITY POST PHERESIS DO Apr 20, 2021 Lab IONIZED CALCIUM DO Apr 20, 2021 Lab IONIZED CALCIUM DO Apr 20, 2021 Lab MAGNESIUM DO Apr 20, 2021 Lab PHOSPHORUS DO Apr 20, 2021 Lab COMPREHENSIVE METABOLIC PANEL DO Apr 20, 2021 Lab DIC PANEL DO Apr 20, 2021 Lab ADAMTS13 ACTIVITY DO Apr 20, 2021 Lab RETICULOCYTES DO Apr 20, 2021 Lab CBC W/ AUTO DIFFERENTIAL PANEL DO Apr 20, 2021 Lab IONIZED CALCIUM DO Apr 20, 2021 Lab LDH DO Apr 20, 2021 Lab TROPONIN I DO Apr 20, 2021 Lab IRON PROFILE DO Apr 20, 2021 Lab QUANT IMMUNOGLOBULIN DO Apr 20, 2021 Lab UNLISTED LABS (RESEARCH, SENDOUTS) DO Apr 20, 2021 Lab S-100B PROTEIN, SERUM (SENDOUT) DO Apr 20, 2021 Lab MAGNESIUM DO Apr 19, 2021 Lab PHOSPHORUS DO Apr 19, 2021 Lab LDH DO Apr 19, 2021 Lab HAPTOGLOBIN DO Apr 19, 2021 Lab B12, VITAMIN DO Apr 19, 2021 Lab FOLATE,SERUM DO Apr 19, 2021 Lab HEPATITIS PANEL DO Apr 19, 2021
CDC Split Type:

Write-up: Presented to ER with subacute malaise and worsening bruising area receiving Johnson & Johnson COVID vaccine 11 days ago, found to have microangiopathic hemolytic anemia and thrombocytopenia, concerning for TTP. He was transferred to Hospital as a direct admit to initiate plasmapheresis. Patient outcome tentative.


VAERS ID: 1385042 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-28
Onset:1921-05-31
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (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: rabeprazole 20 mg tablet,delayed release (1/day ) morphine ER 30 mg tablet,extended release (3/daily ) methocarbamol 750 mg tablet (3/day ) eszopiclone 2 mg tablet (1/day ) gabapentin 400 mg capsule (3/day ) promethazine 12.5 mg tablet
Current Illness: Raynaud''s Disease Degenerative Disc Disease (Lumbar Spine) Sjogren''s Syndrome Systemic Lupus Erythematosus
Preexisting Conditions: Raynaud''s Disease Degenerative Disc Disease (Lumbar Spine) Sjogren''s Syndrome Systemic Lupus Erythematosus
Allergies: Aldomet ErythroMYcin
Diagnostic Lab Data: referred to ER
CDC Split Type:

Write-up: Shortness of breath, chest tightness, or pain


VAERS ID: 1385056 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-09
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: Work       Purchased by: ?
Symptoms: Blister, Pemphigoid, Rash, Skin lesion
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprasole 20mg bid, Rorpinirole 1.0mg 3hs, Azelastine 137mcg 2 sprays each nostril bid, Fluticasone 50mcg 2 sprays each nostril qd, Fexofenadine 180 mg qd, Glucosamine Chondrotin 1500 mg qd
Current Illness: Tooth extraction 1 week prior (took Ibuprofen as needed for pain)
Preexisting Conditions: acid reflux, hay fever, arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Skin lesions (blistering sores) and rash on outer skin all over body, particularly arms, chest, back, legs, hands, feet, scalp consistent with and confirmed by testing to be bullous pemphigoid


VAERS ID: 1385179 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-08
Onset:2021-05-30
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blindness unilateral, Exposure during pregnancy, Photopsia, Third trimester pregnancy, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unison, B6 vitamins - taking as needed to combat nausea during pregnancy Pre-natal vitamins (without iron)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood pressure was measured and was in the normal range; no laboratory tests
CDC Split Type:

Write-up: May 30 at 37+6 weeks pregnant with no pregnancy complications at this time: I experienced temporary vision loss in the field of view of my left eye. My vision in my left eye was obscured by a flashing, arching, lightning that I was afraid might be a sign of retinal or vitreal detachment. I returned to my house (was in a walk) within 5 minutes of the lightning appearing in my vision. I drank water and removed my contacts. The lightning disappeared gradually after about 15 minutes. I went to the ER/Labor&Delivery anyway to confirm I wasn?t having pre-eclampsia (which can cause retinal detachment). My blood pressure was fine, baby?s heart rate was fine, my eyes were checked by my OB and I was evaluated for signs of a potential stroke. There were no observable issues. I was discharged and advised to see an opthamologist. There have been no issues with my eyesight since this event, but I have so chosen to wear my glasses rather than my contacts. I do not think this event is related to the vaccine. I think it is more likely an event related to pregnancy and dehydration.


VAERS ID: 1385189 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test normal, Chest pain, Condition aggravated, Decreased appetite, Dizziness, Fatigue, Fibrin D dimer normal, Glomerular filtration rate decreased, Headache, Influenza, Malaise, Nausea, Pain in extremity, Pharyngeal swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: One hour prior to vaccination-180 mg Allegra, 2-200 mg Tagamet, 60 mg Armour Thyroid, Quercetin plus Vitamin C, 25 mg Benadryl, 3-5 ml vials of Cromolyn Sodium. Taken at noon-400 IU Vitamin D, 25 mg Iron, 2-200 mg Tylenol, 60 mg Allegra, 2-
Current Illness:
Preexisting Conditions: Hereditary Alpha Tryptasmia Syndrome and Hypothyroidism.
Allergies: I have many reactions to medications and foods due to my mast cell illness including all food dyes, many preservatives and additives, specifically reacted to Clindamyacin, Cipro, Cephalexin, Flonase, Afrin, Nexium, B12 shot. I can only eat 17 foods without reacting. Most severe reactions to soy, tomatoes, spinach, processed foods and meats, and react to many others. I also react to chemical smells, perfumes, candles, cleaning products, etc.
Diagnostic Lab Data: D Dimer and Basic Blood panel. All normal except Estimat Glomuerular Filtration rate was a little low.
CDC Split Type:

Write-up: No immediate reaction day of vaccination. By evening had an increase in mast cell symptoms including, dizziness, nausea, severe headache, stomach pain, mild chest pain, fluish feeling, very fatigued. Also severe left leg pain in calf (not a normal mast cell symptom for me). Symptoms still very prevalent by April 13, leg pain was worse, now in both legs. Saw primary physician Dr. He saw no swelling in legs and no treatment done at this time. April 18th headaches and leg pain was so severe went to ER. They ran a D Dimer test to test for blood clots and it was normal. Spoke with my mast cell specialist, Dr. by phone on April 19th and he prescribed 40 mg Prednisone daily for 5 days. Started prednisone on April 24th. When treatment course was finished my mast cell symptoms came back even worse than before, Had throat swelling, in addition to above symptoms. Went to Urgent Care on May 2nd, and they prescribed 60 mg Prednisone for 5 days. After this course of treatment, same thing happened,symptoms returned. Dr. suggested I follow up with my primary physician to make sure there wasn''t something else going on besides mast cell symptoms. Dr. ran blood tests on May 14th, including another D Dimer which was negative. Since tests were normal Dr. prescribed a long term taper of Prednisone which I am currently on as of June 9, 2021. Saw Dr on June 1st for follow up. Continuing prednisone taper for an additional 3 weeks. Symptoms as of June 9, 2021-still very sick. I still can''t eat foods I was eating prior to vaccination, worsening of mast cell symptoms and leg pain is now mild and intermittent which is better. Still have headaches but they are not as severe as they were.


VAERS ID: 1385228 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Anal incontinence, Asthenia, Back injury, Back pain, Blood test, Computerised tomogram, Dehydration, Diarrhoea, Face injury, Fatigue, Hyperhidrosis, Loss of consciousness, Magnetic resonance imaging, Pain, Peripheral swelling, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), 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: No.
Current Illness: No.
Preexisting Conditions: No.
Allergies: No. Just allergies to pollen and dust.
Diagnostic Lab Data: Blood work Cat-scan/ MRI
CDC Split Type: vsafe

Write-up: About 8 hours after the vaccine at 2:30am I had a fever and bad sweats, back and stomach pain, diarreha, lost of bowel control, achy all over. Which prompt me to call for an ambulance. I went into the ER I had to get 3 bags of IV fluids for dehydration, anti-nausea medication, pain medication for back pain because I passed out and hurt my back and cut my face. I also had swollen in my left foot. I am still having fatigue feeling. I still don''t have my energy levels back from before the adverse event.


VAERS ID: 1385289 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-19
Onset:2021-05-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Blood test, Cardiac stress test, Chest pain, Computerised tomogram head, Computerised tomogram thorax, Contusion, Dizziness, Dysgeusia, Dyspnoea, Electrocardiogram, Fatigue, Feeling abnormal, Headache, Limb mass, Myocardial infarction, Pain in extremity, Pain in jaw, Thrombosis, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydromorphone, flexeril, gabapentin, proAir, servent diskus, vit D, vit B, multi vit, hawthorn, red yeast rice, coQ10
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Stress test 6/14 Ct scan head/chest, EKG, ultra sound, blood test 6/2 Blood work 5/24
CDC Split Type:

Write-up: 5/21/21 10:00pm shortness breath, chest pain, shoulder pain, jaw pain, metallic taste, fatigue ?mini heart attack? symptoms 5/26-5/27 trouble breathing, fatigue, light headed 5/29 pain in left arm 5/30 night - second ?mini heart attack? symptoms General fatigue, hard to breath, overall feeling bad 6/2 - bruise on arm and lump Extreme headache, fatigue, chest pain, arm pain Emergency room visit = blood clots


VAERS ID: 1385296 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Bone pain, Computerised tomogram, Condition aggravated, Dizziness, Electrocardiogram abnormal, Feeling abnormal, Headache, Laboratory test abnormal, Loss of consciousness, Loss of personal independence in daily activities, Memory impairment, Migraine, Pain, Post-traumatic stress disorder, Pulmonary mass, Urinary tract infection, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Osteonecrosis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu shot - immediate bad headaches and pain; once it made me feel immediately like I had the flu - 2020
Other Medications: Tylenol; Hydroxyzine Pamoate - every four hours - dosage 50 mg; Trazadone 50 mg -at bedtime one pill; Seroquel - 50 mg - 1 at bedtime; Gabapentin - 600 mg - 4 times daily; Warfarin - blood thinners - take as directed - 10 mg on Monday and a
Current Illness: no
Preexisting Conditions: Was getting better where I could go out and do things and be strong enough to walk etc (I had Mersa in my leg for long term) - with my COMPLEX PTSD - but after the vaccine those have gotten really bad; Bi-Polar; Sleep Apnea; Asthma; High Blood Pressure
Allergies: Brieo Ellipta - for asthma; Aver -for asthma; Vancomycin; Haldrol; Percocet; all the opiates - can''t have
Diagnostic Lab Data: ER - I''ve been twice. May 23, 2021 and then the second visit was 6/2. First time - CAT scans; Bloodwork - complete. They found a lot of things going on in there. I had a small mass in my right lung that I didn''t know I had. I had an abnormal EKG. They said I might have seizures but they didn''t find anything in my brain. I had a UTI and an indication of possible heart disease. 2nd visit: they said I was just dizzy. No medicine given; no antibiotic for UTI.
CDC Split Type: vsafe

Write-up: The next day after vaccine, about 4:00pm - pain hit me and it was so severe I started to throw up from the pain. Short term memory/brain fog has been an issue. I''ve had massive migraines. Complete body aches - even my bones hurt. The worse one was on both of my arms - above the wrist - and it was horrible (mostly on the right). One big blur of pain - I''m in a lot of pain all the time. I have a constant headache. I keep losing consciousness and that started after the vaccine. It use to hit every three hours. Now it''s more than that. I have been two ERs in the couple of weeks. I''ve been to the doctor, too. I am referred to a neurologist - can''t get me in until middle of July. I pass out and when I wake up from it I am in excruciating pain - my whole body hurts. I can only take Tylenol because I''m on Warfarin. I use Tylenol as needed and ice pack and heating pad for the pain. I started to almost lose consciousness when I have been completing this but I''m okay - it is like a blanking out of the moment.


VAERS ID: 1385398 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Asthenia, Blood test, Computerised tomogram coronary artery, Cough, Fatigue, Hypoglycaemia, Nasopharyngitis, Pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (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: I was taking my normal diabetes medication.
Current Illness: None.
Preexisting Conditions: I have diabetes and kidney disease.
Allergies: None.
Diagnostic Lab Data: I had blood work done and a heart scan.
CDC Split Type: vsafe

Write-up: The same evening I got my vaccine I felt very weak and had very body aches. The next day I lost my sense of taste and I felt very tired. I wasn''t able to hold my grandbaby because I just felt very weak. As time went on I had a very bad cough that I couldn''t get rid of. I went to the hospital and I also experienced a sharp pain in my body. I was prescribed some medication to prevent the coughing, this helped some. A couple days later, I couldn''t keep up anything I ate. My coughing was very painful , and was told I probably caught a cold. I was diagnosed with acute hypoglycemia. The hospital also did call to check up on me after. I am just now getting rid of the cough which was around June 9, 2021. The fatigueness has not gone away.


VAERS ID: 1385400 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-29
Onset:2021-06-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood test normal, Cold sweat, Colitis, Computerised tomogram abnormal, Diarrhoea, Diarrhoea haemorrhagic, Injection site pain, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune 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: Started taking Zoloft within last 2 weeks. Cont next pg
Current Illness: n/a
Preexisting Conditions: frequent sinus infections
Allergies: caffeine
Diagnostic Lab Data: Blood tests taken 6/4 normal. CT scan 6/4 showed inflammation diagnosis Colitis. Awaiting results from stool sample submitted on 6/5
CDC Split Type:

Write-up: Initially after injection, the site on my arm was sore for several days. I am not sure that what follows is related to the vaccine, but my mother received the vaccine at the same time I did at the same location and she fell ill on June 4 June 3 around 1pm. I had abdominal pain. During a bowel movement I broke out into a cold sweat with shaking of limbs. That bowel movement turned into diarrhea. Then finished with nothing but dark blood. I rested for a bit as I was having abdominal pain and still having dark blood as a bowel movement. 2-3 times. When I got a change, I phoned my Primary Care Physician''s office. It was after hours and I spoke with a colleague that suggested I go to the ER to get checked out.


VAERS ID: 1385418 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-03
Onset:2021-06-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Exposed to RSV
Preexisting Conditions: Unknown
Allergies: No
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient had site redness, fever, and swelling. She went to ER and was diagnosed with cellulitis and placed on antibiotic therapy (cephalexin). Now site is improving well.


VAERS ID: 1385423 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Dizziness, Flank pain, Headache, Herpes zoster, Joint swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Opportunistic infections (broad)

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

Write-up: Shingles Headaches dizziness pain in lower right side front very bad constant swelling in feet, toes, ankles, legs, and hands leg gave out


VAERS ID: 1385480 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-07
Onset:2021-04-27
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dyspnoea, Electrocardiogram, Hypertension, Tachycardia, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), 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: Metformin HCL Metoprolol Tartrate Buspirone Levothyroxine Lamotrigine Aspirin Cinnamon plus Chromium Magnesium Vitamin D3 Folic Acid Gabapentin Letrozole Trazadone Pravastatin Fish Oil Melatonin plus Lemon Balm Elderberry Daily Fiber Womans
Current Illness: None
Preexisting Conditions: -Type 2 diabetic-non insulin -High bp / high cholesterol -Anxiety / depression / bipolar2 -extreme needle phobia -Thyroid micro papillary carcinoma resulted in total removal of thyroid. (11.2011) -gallstones (mild - diet controlled) -Divriticulitus (re-occuring mild - diet controlled) -Bursitus in right hip (mild) - migraines - possible trigeminal neurolgia (not consistant/may be migraine related) -Invasive Lobular Carcinoma (03.2020) -Mild Neuropothy -diagnosed and treated severe ADHD in youth
Allergies: sulfa bactrim - hives lipitor - aching reaction amoxicillin - rash topirimate - bruising/heart palp biaxin - hives nortriptiline - high blood sugar zoloft - hives Rosuvastatin - bruising/cramping latex-minor tingle/itch
Diagnostic Lab Data: on vacation 04.24 to 05.01. Hotel dr checked me out 04.30 and had me take extra medication. ER visit 05.02 with bloodwork, ekg, and xray. Cardiologist visit 05.03. Raised daily medication and Ordered 30 day holster monitor (completed 06.08.20). ER visit 05.20 with bloodwork, ekg, and xray. ER visit 06.04 for gallbladder attack Meet with cardiologist 06.21 to review monitor results.
CDC Split Type:

Write-up: Multiple incidents of very fast heart rate, high blood pressure, and shortness of breath.


VAERS ID: 1385482 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-26
Onset:2021-04-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Decreased appetite, Dysphagia, Fatigue, Pyrexia, Throat irritation, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: He had blood work and urinalysis and everything was OK.
CDC Split Type:

Write-up: He got his vaccine, he had the fever that evening. Overnight he started vomiting some brown gunk that looked like dried up blood from 1:00-2:00 AM. He did not have much of an appetite. This continued the following night around the same time. Then he started vomiting again the third day after the vaccine, and he vomited after work and was pretty much vomiting nonstop and started having difficulty in swallowing. Feeling fatigued. On Thursday morning at 2:00 AM he went to the ER on 4/29/21 and they prescribed him some anti-vomiting medication. That worked for about a day. On Friday he started spitting into a cup and spit about 3-5 cups of spit. On Saturday he went to the hospital on 5/1/21 and looked in his throat and said that he had some acidic burns from the vomiting and prescribed him Ondansetron 4 mg for the vomiting, which he did not take much of. They also prescribed him Diphenhydramine elixir to soothe his throat which he took every 6 hours which worked like wonders he said. He started to feel better after that point. He tested negative for COVID in the negative. He did have COVID in November of 2020, and he had vomiting at that time as well. He was sick with COVID for about a week. He did not have much of an appetite either. He also felt very fatigued and felt better following Thanksgiving and tested negative the Monday after Thanksgiving. The fatigue symptoms lasted about 3 weeks after he tested negative, so he was sick for about a month in total.


VAERS ID: 1385507 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral, Arteriogram carotid, Chest X-ray, Chest discomfort, Chills, Choking, Computerised tomogram head, Computerised tomogram neck, Computerised tomogram thorax, Dry throat, Endoscopy, Magnetic resonance imaging head, Magnetic resonance imaging neck, Paraesthesia, Spinal X-ray, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, Advil, Vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CTC, CTA, MRI, X-ray for chest, neck, telescope to throt. medication provide. - Atorvastatin 40 mg (reduce 10 mg), Sertraline 25 mg Alprazolam 0.25 mg Omeprazole 40 mg Baby Aspirin,
CDC Split Type:

Write-up: Very dry throt, chocking, chill. body shacking, chest tightness, twinging in arm and legs, Visit Emergency room for 3 time ( around every 8 days) test - X-ray for chest, Neck, CTC - chest, neck, head CTA- neck, head MRI - neck, head telescope to check throt by ENT visit to - ER 3 time, admitted to hospital at 3rd time, visit to ENT, GI, Polemology, Neurology, Symptoms still as is, little better than before.


VAERS ID: 1385509 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-01
Onset:2021-05-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Computerised tomogram, Craniotomy, Headache, Subdural haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Supraventricular tachyarrhythmias (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit B12 1000 mg , Vit D3 2000 iu
Current Illness: No
Preexisting Conditions: None
Allergies: Nka
Diagnostic Lab Data: Ct scan 5/21 @ hospital; 5/22 - Craniotomy.
CDC Split Type:

Write-up: Persistent headache found to be a large subdural hematoma. Hospitalized after surgery x 7 days from 5/22- 5/28. Also onset of AFib.


VAERS ID: 1385528 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-09
Onset:2021-06-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: hives with pfizer
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: hx hives with pfizer vaccine from store (lot unknown)
Diagnostic Lab Data:
CDC Split Type:

Write-up: began feeling itchy again, transferred to ER


VAERS ID: 1385881 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-09
Onset:2021-05-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Cough, Fatigue, Lower respiratory tract infection, Myalgia, Nasopharyngitis, Rash, Rash pruritic, Rhinorrhoea, Sinus congestion, Sneezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Voltaren 2x daily
Current Illness: None
Preexisting Conditions: None except bad knees
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had the following events: muscle & joint pain, persistent tiredness for 4 days following the shot. On the 3rd day following the shot I started sneezing regularly and having a stuffy head & runny nose. This lasted about 4 days. After the sneezing started to subside I started experiencing a nasty head cold which then traveled to my chest and lasted for about 5 days. Was coughing all day long. Once those symptoms started to subside, about 2 and a half weeks after the shot, I broke out in a body rash which I''m still dealing with today and seems to be getting a little worse. I''m currently at a dermatologist in the waiting room filling out this report. The rash is very itchy & at times a tad painful.


VAERS ID: 1385988 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-23
Onset:2021-06-04
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Deep vein thrombosis, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: right leg ultrasound, CT chest
CDC Split Type:

Write-up: DVT and PE thought provoked after long care ride


VAERS ID: 1386046 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-07
Onset:2021-05-07
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse event, Asthenia, Blood test, Dyspnoea, Heart rate increased, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), 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), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ecotrin81mg, B-12 2500mcg, Probiotic, Folic Acid 400mcg, D3
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillins and Amoxicillin
Diagnostic Lab Data: Several Blood Tests taken. May 9, 10, 12, 17th 2021 June 03, 2021
CDC Split Type:

Write-up: Severe Immune Response. Fever, Rash, Itching, High Heart rate, Weakness, Shortness of breath. Treated at Emergency room May 09, 2021 Follow up office visit with Dr May 10, 2021 May 12, 2021 May 17, 2021 and June 03, 2021


VAERS ID: 1386056 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-06-07
Onset:2021-06-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness unilateral, Chest discomfort, Computerised tomogram normal, Dehydration, Dyspnoea, Electrocardiogram normal, Hypoaesthesia, Peripheral swelling, Peripheral vascular disorder, Pyrexia, SARS-CoV-2 test negative
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), COVID-19 (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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: penicillin
Diagnostic Lab Data: pt''s mom reporting all info.. ~ pulse ox 82 -96 ~ hr 111 ~ chest tightness -hospital admin diazepam ~ekg = okay ~needed fluid ~ history pneu - ct scan no clots ~ covid negative, no fever, no cough ~follow up this monday the 14th ~we filled Oxycod/Acet 5/325mg Diazepam 5mg and Ondansetron ODT 4mg was at hospital for about 10 hours
CDC Split Type:

Write-up: pt mom reports on Tuesday morning. PT HAS FEVER, SWELLING OF LEGS, SHORTNESS OF BREATHE, NO BLOOD FLOW IN EXTREMETIES. PT REPORTS FEELING NUMBNESS IF EXTREMETIES. CANT SEE OUT OF HIS RIGHT EYE, REFERRED TO hospital.


VAERS ID: 1386066 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-08
Onset:2021-06-08
   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: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest pain, Dizziness, Nausea, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Methylphenidate, Lexapro, Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: Tree nuts, Sulfa drugs, cats, dogs, ragweed, dust, pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylaxis as a result of COVID-19 vaccination. Chest pain, chest burning, swollen tongue, nausea, dizziness, lightheadedness.


VAERS ID: 1386068 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-09
Onset:2021-06-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Condition aggravated, Electrocardiogram, Hyperhidrosis, Pallor, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Status post receiving J&J on left deltoid. Patient stated he has a fear of blood prior to receiving the vaccine. Patient went to the observation area and was noted to have a syncopal episode witnessed by RN. Patient was noted to be pale and diaphoretic. Patient was lowered to the ground by two (2) RNs. RN held c-spine while lowering patient to the floor. He was nonresponsive for approximately 30 seconds. No injuries were noted. After being lowered to the ground in supine position, patient was A/Ox4. Vital signs were assessed as follows: O2 was 98%. HR was 65. Temperature was 98.1. BP was 116/75. Respirations were 16. Patient stated he has a history of a similar incident that happened 7 years ago when he cut his finger he "passed out." EMS was called at 1425 and arrived at 1430 and assisted him into a chair. Upon checking his blood sugar, patient immediately had a second syncopal episode/LOC while EMS was on scene. Patient was again lowered to the ground in supine position. EMS performed a 12 lead EKG and transferred him to a stretcher. Patient A/O x4 prior to EMS departure. EMS left with the patient at 1445.


VAERS ID: 1386100 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Constipation, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Severe abdominal pain, constipation.


VAERS ID: 1386136 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-09
Onset:2021-06-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 LA / IM

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

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

Write-up: AFTER THE VACCINATION, PATIENT WALKED TO THE OBERSERVATION CHAIR AND HE FAINTED WHEN HE GOT TO THE WAITING STATION. PATIENT FELL AND HIT HIS HEAD, HE WAS UNCONSIOUS FOR ABOUT 10 SECONDS THEN WOKE UP AFTER BEING HELPED BY THE PHARMACIST AND LOCAL MEMBERS. HE WAS AWARE OF THE DATE, DAY, MONTH, AND WHERE HIS LOCATION. PT HAS NO DIFFICULTY IN BREATHING OR SPEAKING. HOWEVER, PATIENT HAD HIT HIS HEAD AND HE WAS TAKEN AWAY WITH THE PARAMETIC.


VAERS ID: 1386178 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UJ371AB / 1 RA / SC

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Hypersensitivity, Nausea, Pharyngeal swelling, Respiratory tract congestion, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 11:08 Text from client''s mom: allergic reaction, throat swelling and hives all over. Client took Benadryl. Instructed to go to ER and ask them to complete a VAERS form. The mom texted back,: he took some Benadryl and it was about 30 minutes and he could feel things staring to go down and he feels a ton better, so I think we are OK. At 1:02 PM I texted her "How is he doing?" Her reply: "Much Better." At 5:11 PM Client''s mom called and said patient was having chest congestion, swelling in his throat and sick to his stomach and nausea. I instructed her once again to get him to the ER . Client took Benadryl once again and also went to the ER. At 6:36 PM Client''s mom let me know they were giving him an epinephrine shot and a steroid shot. she also texted: Dr. has never seen this kind of reaction. 6/3/2021 9:30 AM Client "so much better, thank goodness. 6/8/2021 Client himself stated he was fine. No additional problems


VAERS ID: 1386209 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-06-09
Onset:2021-06-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Pruritus
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient noted her arm was very itchy within minutes after administration. Patient was given 50mg oral Benadryl and noted the syrup was difficult to swallow. An EPI Pen was administered at that time as well as 911 called. Patient''s BP was 156/124 with HR 106. Patient was responsive and stable until EMS arrived. Patient was taken to the hospital where she received treatment and is now feeling fine awaiting discharge.


VAERS ID: 1386394 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN EWO182 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: International normalised ratio normal, Pain in extremity, Skin discolouration, Ultrasound scan normal
SMQs:, Hypotonic-hyporesponsive episode (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: Aspirin 81 mg, 1 tablet(s) by oral route, 1 time per day Clopidogrel 75 mg, 1 tablet(s) by oral route, 1 time per day, for 30 days Warfarin 5 mg, 1-2 tablet(s), 1 time per day, 1.5 tabs 5 days a week; 2 tabs 2 days a week Atorvastatin 80 mg
Current Illness: None
Preexisting Conditions: Cardiovascular disease, high blood pressure, blood clotting - I had a portal vein clot in 2003 (approx).
Allergies: None
Diagnostic Lab Data: They ran an ultrasound on areas of my arm that were unaffected (why? I don''t know). They checked my INR since I''m on blood thinners, which was normal.
CDC Split Type:

Write-up: I had no symptoms until the next morning when I woke up with very extreme pain in my left arm with the epicenter of the pain on the back of my left hand between the bones leading to the ring finger and the pinky. Whenever my hand was below my heart, the entire hand was dark purple in color. I had read that severe reactions from the shot generally dissipated in a day so I took some Hydrocodone which I had for migraines, kept my hand elevated, and decided to wait it out. The next day the pain was still extreme so I went to urgent care. Urgent care eventually said I needed to go to the emergency room to have an ultra-sound. I did so. After many hours of waiting, they got me into the ultrasound room where they told me they cannot ultrasound the back of the hand because the vessels are too small and don?t show up. So they ran an ultrasound on the shoulder and front of the arm and found nothing. I?m not surprised as that is not where the pain was coming from. I went home and alternately put my left hand in ice water and hot water periodically, which eventually reduced the pain to a tolerable amount. As of today, all the pain is gone except for the region mentioned in the back of the hand. That still hurts, so I''m answering item 20 with a No.


VAERS ID: 1386607 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood test normal, Chest X-ray normal, Depression, Disorientation, Dizziness, Dyspnoea, Electrocardiogram normal, Euphoric mood, Muscle twitching, Nervousness, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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: Meningitis I developed a rash for 3 weeks.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Bloodwork EKG, chest x-ray, all came back normal.
CDC Split Type: vsafe

Write-up: 04/28/2021 I felt dizzy, after a few days I felt my legs and feet tingly, a few days more and I felt euphoric then depressed, after that I was okay. I might have had some tingling, but nothing too bad. 2 days before May 20th, 2021, I started feeling nervous then I went to ER, due to feeling lack of oxygen , I was disoriented, dizzy, fainting type of dizzy. I could not breathe, I laid down and I could not breathe and my hands were tingling, then it went away at ER, but then it came back. After that my feet were tingly for days on and then my eyes were twitching, this was 4 days after the ER, 1 week, now I am recovered. I still have some abdominal pain.


VAERS ID: 1386827 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-26
Onset:2021-05-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood electrolytes, Blood test, Dizziness, Dyspnoea, Electrocardiogram, Paraesthesia, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Anaphylaxis response to Moderna vaccine (#1) on 03/26/2021
Other Medications: Prednisone, Imuran, Benlysta, Methadone, Lopressor, Norvac, Hipex, Evoxac, Vit D, Calcium
Current Illness: Lupus
Preexisting Conditions: Lupus, Transverse myelitis, CIPO
Allergies: Vancomycin, Lyrica,Cipro family. Sulfa family, HydroCHLORO-thiazide, Moderna vaccine
Diagnostic Lab Data: At emergency room they did blood tests, CMC and electrolytes, and an EKG.
CDC Split Type:

Write-up: 35 minutes after injection experienced dizziness, shortness of breath, tingling of lips, tongue, fingers and toes. Went to nearest Emergency room, 8 minutes away. Treated with IV Solumedrol, Benedryl, and Pepsid. Stabilized and discharged after 2 hours. Minor symptoms for 2-3 more days. Back to normal now.


VAERS ID: 1386865 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-04
Onset:2021-05-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Bone pain, Chest pain, Insomnia, Laboratory test, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (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:
Diagnostic Lab Data: Patient stated that he had a number of tests done in the ER.
CDC Split Type:

Write-up: Patient stated that starting 3 days after vaccine he started with pain in his left arm and chest, pain in his joints to his bones. He says he has trouble sleeping. He did go to the Emergency Room and was evaluated. He says he still currently has the pain.


VAERS ID: 1387477 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-05-26
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Dyspnoea, Heart rate, Heart rate decreased, Hyperhidrosis, Hypotension, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (Minimal consumption); Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and no drug abuse or illicit drug usage. The patient had no past medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210526; Test Name: Heart rate; Result Unstructured Data: low; Test Date: 20210526; Test Name: Blood pressure; Result Unstructured Data: 70/34 mmHg
CDC Split Type: USJNJFOC20210607523

Write-up: UNRESPONSIVE; DIFFICULTY BREATHING; DIAPHORETIC; BLOOD PRESSURE 70/34; LOW HEART RATE; This spontaneous report received from a patient concerned a 34 year old white and not Hispanic or Latino male. The patient''s weight was 134 pounds, and height was 69 inches. The patient''s concurrent conditions included alcoholic, and non smoker. The patient had no known drug allergies and had no past medical history. The patient did not have any 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 expiry: 23-JUN-2021) dose was not reported, 1 total, administered on 26-MAY-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. On 26-MAY-2021, after administration, the patient had a somewhat severe reaction with difficulty breathing and went unresponsive. The patient did not remember much. The Emergency Medical Services (EMS) were called and the pharmacist gave an epi pen shot to the patient. The patient was diaphoretic and unresponsive when they arrived. The EMS slowly monitored the patient and as epi kicked in and the patient came back to life. The patient''s blood pressure was 70/34, and that, along with it his heart rate, started to rise. The whole process lasted 45 minutes. The EMS wanted to take him to hospital, but the patient refused. On 26-MAY-2021, Laboratory data included: Blood pressure (NR: not provided) 70/34 mmHg, and Heart rate (NR: not provided) low. Treatment medications included: epinephrine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from unresponsive on 26-MAY-2021, and the outcome of difficulty breathing, diaphoretic, blood pressure 70/34 and low heart rate was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210607523-COVID-19 VACCINE AD26.COV2.S-Unresponsive, difficulty breathing, diaphoretic, blood pressure 70/34, low heart rate. 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: 1387853 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-27
Onset:2021-05-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest X-ray normal, Chills, Cough, Dyspnoea, Fatigue, Headache, Nasal congestion, Nausea, Pain in extremity, Pyrexia, SARS-CoV-2 test positive, Somnolence, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A I had an arm injury but that was it. The injury was in my left arm so I got the vaccine in my right arm.
Preexisting Conditions: N/A None prior to getting the vaccine other than slight irregularity of my monthly cycle.
Allergies: N/A
Diagnostic Lab Data: COVID POCT test- positive Chest X-ray- normal Fever- present
CDC Split Type:

Write-up: Chills and shaking 05/27/2021 Cough, fatigue, pain in legs 05/27/2021-05/30/21 I slept nearly all day 05/31/21- 06/02/21 Difficulty breathing + coughing 06/05/21-06/07/21 Fever, pounding headache, Shortness of breath, pain in arms 06/08/2021 Shortness of breath, pain in abdomen, headache, nose feels like it?s underwater, nauseous 06/09/2021


VAERS ID: 1387942 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Echocardiogram, Electrocardiogram, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Turmeric MSM and Glucosamine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG 5/20; Blood Panel 5/20, Ecocardiogram 5/20, CT w. Iodine Scan 5/26; Blood Tests 5/26, 5/27, TEE 5/27
CDC Split Type:

Write-up: 4 Days after vaccine (4/16/21), elevated heart rates while running/exercising. Max HR was 195+ for 46/yo Male. This continued during running for more 12 days (4/28/21), and seemed had resided on 4/29/21. Note: Prior to vaccine only had two runs with a max HR higher than 190, both of those were strenuous endurance events (high altitude or sprinting). 10 Days after the high heart rates, on 5/10 patient experienced another spike in heart rates, and a few. On 5/18 another high heart rate episode occurred but patient didn''t see heart rate recover. Patient utilized a new smart watch to check ECG and watch diagnosed they were in AFIB. Patient visited doc / ER and while in ER came out of Afib, patient was placed on Metropol. Patient back into Afib 1 week later, admitted to hospital to undergo Cardioversion. Patient is still working with cardiologist and internist to determine next steps.


VAERS ID: 1387986 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-06-07
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Chest X-ray normal, Computerised tomogram abdomen normal, Deep vein thrombosis, Ecchymosis, Erythema, Pelvic venous thrombosis, Peripheral swelling, Peripheral vein thrombus extension, Ultrasound Doppler abnormal, Urine analysis normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (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)

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: Parkinson''s Disease, HTN, GERD, chronic pain, depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED on 6/7/21 with abdominal pain that had started earlier that day. CT abdomen, CXR, and urinalysis were done and all came back negative. Patient denied any respiratory symptoms. On physical exam, he was found to have severe swelling, erythema, and ecchymosis on his left leg extending into the upper thigh and knee. A lower extremity doppler was done and found extensive occlusive thrombosis within the left lower extremity beginning in the external iliac vein and extending into the common femoral, femoral, profunda, popliteal and visualized deep calf veins. No evidence of PE or DVT in the RLE was found. Vascular Surgery was consulted, who did not recommend any procedures, but patient was started on a heparin drip. Hematology later saw the patient and changed the heparin drip to rivaroxaban on 6/9/21. Infectious Diseases was also consulted for possible sepsis.


VAERS ID: 1387996 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-05-10
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-27
   Days after onset: 17
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: Non-ST elevation (NSTEMI) myocardial infarction RESPIRATORY DISTRESS


VAERS ID: 1388070 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Eating disorder, Gastrointestinal disorder, Ultrasound Doppler, X-ray
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: No
Preexisting Conditions: No
Allergies: Soy
Diagnostic Lab Data: I had blood work done, X-rays and an ultrasound 2 days ago while I was in the ER. I am going to see a specialist soon.
CDC Split Type:

Write-up: I have had gastrointestinal issues since the day after relieving the shot, I spent the night in the ER because of it 2 days ago. For 3 weeks I have not been able to eat without being in excruciating pain.


VAERS ID: 1388088 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-10
Onset:2021-06-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient fainted and loss consciousness for approximately 1 minute about 5 minutes after being vaccinated. Patient was pale, and had shallow breathing.


VAERS ID: 1388188 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-05-19
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Erythema, Rash, Skin mass, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (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: None taken
Current Illness:
Preexisting Conditions: Diabetes, RA, pseudo tumor cibre, asthma, thyroid, depression
Allergies: Imitrex, white eggs
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: After my vaccine, I broke out in a rash, felt like someone was burning me, like if I was burning me alive, hard to explain. It was a rash then the rash turned into these big red mass, these lumps were nasty and I could not sleep for three days. They were on my arms and legs, stomach, back, parts of my face. The rash went away and came back, was on different parts of my body. I went to the ER to get checked out but at the ER they did not do any exams for me, they just told me I had hives. It took 4-5 days for my hives to go away. I still get these little bumps, they are small growing around my back, chest and legs and at the bottom of my legs and body and they do not itch.


VAERS ID: 1388270 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Condition aggravated, Disorientation, Epidural injection, Eye disorder, Fibromyalgia, Hypoaesthesia, Impaired work ability, Inflammation, Joint swelling, Neuralgia, Paraesthesia, Peripheral swelling, Spinal pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Retinal disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (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: Eliquis, aspirin 81 mg, Metoprolol Succinate, Atorvastatin, duloxetine, Montelukast, Trulicity, Humalog, Topiramate, NovoLog.
Current Illness: Environmental allergies.
Preexisting Conditions: Spinal stenosis, fibromyalgia, diabetes, high cholesterol, high blood pressure, osteoarthritis, A-fib, tachycardia, sleep apnea.
Allergies: Iodine (anaphylaxis), octafluoropropane gas from echocardiogram (swelling and pain of bottom of feet, swelling of lower extremities, neuropathy pain). Shrimp, tuna and coconut have tendency to cause itchiness of lips, excessive salt also causes itchiness of her lips, Isoniazid (drug-induced lupus).
Diagnostic Lab Data: As above.
CDC Split Type:

Write-up: She got her vaccine at about 6:30, and the bottom of her foot started swelling, then the to of her foot, ankle, tingling of her feet (both), neuropathy pain came back which she hadn''t had in a long time. The spinal stenosis pain came back very strongly and her fibromyalgia pain came back and they were all pretty well managed prior to the vaccine. She is still having that pain. She is on a pain management regimen to control her pain prior to the vaccine, and then it has worsened and was scheduled for an epidural spinal shot and not able to get off the Eliquis due to the vaccine and that has been postponed. She was on Duloxetine for the neuropathy pain and it had been being managed and then all of a sudden that pain has worsened and the medicine she was taking for that did not work anymore. She went to the ER on 5/5/21, and they gave her Morphine for the pain, and discharged her home with Tramadol. The 2nd ER visit was on 5/15/21, as when she woke up both of her legs were numb, and could not feel her legs from her ankle to her hip/waste area. When she opened her eyes she thought she was looking at the side wall and was looking at the ceiling and could not discern where she was, was disoriented and called her doctor and told to go to the ER. She went to the ER and they finally took it seriously and they suggested that she had inflammation in her system that was causing her other problems to flare up. She made appointments with her specialists to see where the inflammation was. She then saw a rheumatologist as when she went to the ER the 2nd time they wanted to put her on steroids and she did not want to be put on it due to her diabetes. She did have drug-induced lupus at one point from isoniazid. Her rheumatologist confirmed she did have inflammation on blood work and told her to take the steroids. The steroids have taken down some of the pain, but not completely. She did have a lumbar epidural steroid injection yesterday 6/9/21 at L4 bilaterally, which has helped as of today. She was put on Tramadol after the first ER visit by her pain management doctor and that did not work. After that she was switched to Hydrocodone which has helped her. Her cardiologist, rheumatologist and PCP told her that it hit things that impacted her nervous system and that she has inflammation in her system, does not know exactly where it is and it has impacted her system and caused intensity of her spinal stenosis, neuropathy and fibromyalgia. She is still undergoing treatment for these symptoms. She was not feeling her neuropathy pain hardly at all prior to the vaccine. On She woke up and both of her legs were numb, and could not feel her legs from her ankle to her hip/waste area. When she opened her eyes she thought she was looking at the side wall and was looking at the ceiling and could not discern where she was, was disoriented and called her doctor and told to go to the ER. She has not been able to return to work as a teacher due to the reaction she has been having. She wants to know what the efficacy is now that she has had a reaction or has it lessened or does she have any protection at all now.


VAERS ID: 1388287 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-10
Onset:2021-03-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Condition aggravated, Confusional state, Electrocardiogram, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-17
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine furosemide
Current Illness: intractable vomiting pericardial effusion COPD Hypothyroid Dementia
Preexisting Conditions: pericardial effusion COPD Hypothyroid dementia
Allergies: sulfa drugs
Diagnostic Lab Data: EKG Chest XRay
CDC Split Type:

Write-up: vomiting, confusion


VAERS ID: 1388291 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-07
Onset:2021-03-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Magnetic resonance imaging, Pain in extremity, Scan with contrast, Ultrasound scan, X-ray limb
SMQs:, Guillain-Barre syndrome (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: MRI. 04/ 06/2021 of r shoulder Sonogram of r arm in ER X-rays of r arm 04/21/2021 MRI with contrast of r shoulder 06/08/2021
CDC Split Type:

Write-up: Pain in right arm after receiving vaccination and increasing pain and weakness progression


VAERS ID: 1388407 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-05-08
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Flank pain, Pyelonephritis acute
SMQs:, Retroperitoneal fibrosis (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: Acute pyelonephritis flank pain


VAERS ID: 1388436 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-10
Onset:2021-06-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Oropharyngeal pain, Pregnancy, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Normal pregnancy conditions and outcomes (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: Prenatal vitamins
Current Illness:
Preexisting Conditions:
Allergies: Blackberries and penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pregnant Trouble breathing Congestion Fever Sore throat


VAERS ID: 1388604 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Blood creatine phosphokinase increased, Computerised tomogram, Condition aggravated, Dehydration, Fatigue, Headache, Laboratory test, Magnetic resonance imaging, Post concussion syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Accidents and injuries (broad), Dehydration (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril (PRINIVIL/ZESTRIL) 10 mg Oral Tab Take 1 tablet by mouth daily Torsemide (DEMADEX) 100 mg Oral Tab Take 1 tablet by mouth daily LORazepam (ATIVAN) 1 mg Oral Tab DECREASING MEDICINE. TAKE 1 TABLET BY MOUTH EVERY 4-6 HOURS WHILE
Current Illness: hypothyroidism long term recovery from traumatic brain injury
Preexisting Conditions: DM 2 W POLYNEUROPATHY ESSENTIAL HTN POSTCONCUSSION SYNDROME PSYCHOGENIC MUSCULOSKELETAL DISORDER SEVERE OBESITY, BMI 60-69.9, ADULT 3-MEDIUM ADULT OBSTRUCTIVE SLEEP APNEA, MODERATE BEHCETS SYNDROME DIASTOLIC HEART FAILURE, CHRONIC FIBROMYALGIA HX OF THYROIDECTOMY HYPOGAMMAGLOBULINEMIA MIXED HYPERLIPIDEMIA NONALCOHOLIC STEATOHEPATITIS POSTOPERATIVE HYPOTHYROIDISM 4-LOW ARTHROPATHY OF RIGHT ANKLE GERD (GASTROESOPHAGEAL REFLUX DISEASE) IRRITABLE BOWEL SYNDROME LOW BACK PAIN NECK PAIN OSTEOARTHRITIS OF BILAT KNEES OSTEOARTHRITIS OF RIGHT ANKLE PERIPHERAL VENOUS INSUFFICIENCY 5-LOWEST ALTERNATING EXOTROPIA BILAT DRY EYE SYNDROME BILAT MYOPIA BILAT POSTERIOR SUBCAPSULAR CATARACT COGNITIVE DEFICIT IN COMMUNICATION SKILLS FOOD INTOLERANCE HX OF CHOLECYSTECTOMY HX OF ENDOMETRIAL ABLATION HX OF RENAL CALCULUS LIVER CYST LYMPHEDEMA RIGHT POPLITEAL CYST
Allergies: Acetaminophen Dyspnea High Allergy 2/14/2019 Past Updates... Other reaction(s): Breathing Problems Atorvastatin Calcium Angioedema, Diarrhea High Allergy 4/30/2018 Past Updates... Diarrhea, Facial Swelling Bean High Allergy 8/20/2010 Past Updates... Chocolate High Allergy 8/20/2010 Past Updates... Egg White Anaphylaxis High Allergy 4/7/2015 Past Updates... Other reaction(s): Anaphylaxis abd pain/cramping/diarrhea + hives Eggs (edible) Anaphylaxis High Allergy 8/20/2010 Past Updates... Other reaction(s): Other (See Comments) abd pain/cramping/diarrhea + hives Oxycodone Wheezing High Allergy 5/17/2016 Past Updates... Bradycardia, airway constriction Oxycodone-acetaminophen Anaphylaxis, Patient Reports, Reaction Unknown High Allergy 12/10/2004 Past Updates... bradycardia Oxycodone-aspirin Asthma and/or Shortness of Breath, Anaphylaxis, Wheezing High Allergy 6/17/2008 Past Updates... Other reaction(s): Airway Constriction Pine Trees High Allergy 8/20/2010 Past Updates... Procaine Hydrochloride Angioedema, Headaches High Allergy 9/3/2019 Past Updates... Facial swelling/headache Propoxyphene Napsylate Dyspnea High Allergy 3/12/2018 Past Updates... Breathing Problems, bradycardia Soy Protein High Unspecified 8/20/2010 Past Updates... Sulfa (sulfonamide Antibiotics) High Contraindication 3/7/2008 Past Updates... Empagliflozin Other Medium Allergy 2/22/2019 Past Updates... Urinary tract infection, pyelonephritis. Aspirin Not Specified Allergy 2/14/2019 Past Updates... Dulaglutide Not Specified Unspecified 2/14/2019 Past Updates... Propofol Not Specified Unspecified 9/16/2019 Past Updates... Banana Low Allergy 4/7/2015 Past Updates... Beef-derived Products Low Contraindication 2/8/2019 Past Updates... Carrot Juice Low Allergy 4/7/2015 Past Updates... Chicken Derived Low Contraindication 2/8/2019 Past Updates... Flavoring Low Unspecified 4/7/2015 Past Updates... Gelatin Low Unspecified 2/8/2019 Past Updates... Insulin Glargine Other Low Allergy 7/30/2018 Past Updates... Possible pancreatitis - states that this was the only medication they stopped, and her pancreatitis resolved. Metformin Diarrhea Low Unspecified 3/15/2018 Past Updates... Pregabalin Swelling Low Allergy 8/7/2019 Past Updates... swelling Yeast Protein Low Unspecified 4/7/2015 Past Updates... Adverse Reactions/Drug Intolerances Midazolam Hcl Patient Reports, Reaction Unknown Medium Intolerance 12/23/2015
Diagnostic Lab Data: ED visit with CT scan, CTA head and neck, MRI, labs, multiple follow-up labs and ED visits
CDC Split Type:

Write-up: Dehydration, fatigue, exacerbation of post-concussive syndrome, elevated CK, headache


VAERS ID: 1388886 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-31
Onset:2021-05-06
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10808980 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling, Thrombosis
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), Tendinopathies and ligament disorders (broad)

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

Write-up: pt started with arm pain that would not go away. On May 6, 2021 her arm swelled up to 3 times its size. She went to an urgent care and was diagnosed with a blood clot. She was given a prescription for Eliquis. She was not hospitalized and is doing OK now. She reported this to us on 06/10/2021


VAERS ID: 1388913 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-07
Onset:2021-06-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Carotid artery aneurysm, Chest pain, Computerised tomogram, Dyspnoea, Facial paralysis, Headache, Paraesthesia, Sinus tachycardia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: CT SCAN SHOWED ANEURYSM LEFT CAROTID TERMINUS
CDC Split Type:

Write-up: 19 YRS OLD MALE. NO KNOWN MEDICAL HISTORY. SEVERE HEADACHE, FACIAL DROOP, TINGLING SENSATION ALL OVER HIS BODY. CHEST PAIN, SOB, BLOOD WENT UP. SINUS TACHYCARDIA.


VAERS ID: 1388927 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-27
Onset:2021-06-07
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Cardiac monitoring normal, Electrocardiogram normal, Hypertension, Mobility decreased, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Hypertension (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient''s arm was sore and continued to hurt to the extent it was difficult to raise above her head. On 6/7/21, she experienced high blood pressure of $g200 systolic and sought care at the ED since she was also having left arm pain. EKG, bloodwork and heart monitoring all indicated no cardiac issues. ED provider recommended acetaminophen for the pain. Blood pressure continued to stay somewhat elevated on 6/8/21 but had returned to baseline by 6/9/21 and patient was feeling better.


VAERS ID: 1388947 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Depersonalisation/derealisation disorder, Dizziness, Dysaesthesia, Fatigue, Malaise, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: At approximately 8pm the day of the vaccination, I felt fatigued. I woke up the next morning feeling like I was definitely sick with the typical symptoms. I was resting all morning on the couch at the house I was dog sitting. At around 11:30am I took my daily Claritin and two ibuprofens. At around 12:15pm, I was getting my haircut and felt like I was going to pass out. I asked the hairstylist to grab water and something to cool me off. I didn''t have much control of my body, ED was called, and paramedics showed up. About 5 minutes into the incident my arms and legs started tingling and felt like someone was trying to twist my skin. An IV was put into me and about 5 minutes later I snapped out of the episode.


VAERS ID: 1389031 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-06-02
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Occasionally ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound done on my left leg.
CDC Split Type:

Write-up: I developed a blood clot. I went to an urgent care and was directed to the emergency room.


VAERS ID: 1389053 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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: Pt passed out


VAERS ID: 1389178 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-05
Onset:2021-05-15
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D, Eliquis, Tramadol, Rexulti, Pantoprazole, Benzonatate, Lorazepam, Wixela
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented with symptoms of DVT on 05/15 at Urgent Care. Was admitted to ER on 05/17 to treat DVT


VAERS ID: 1389208 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-08
Onset:2021-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COPD exacerbation/shortness of breath.


VAERS ID: 1389240 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A214 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest discomfort, Chest pain, Cough, Diarrhoea, Eating disorder, Electrocardiogram normal, Eye movement disorder, Feeling abnormal, Gastrointestinal disorder, Head discomfort, Insomnia, Muscle spasms, Muscle tightness, Muscle twitching, Nausea, Nystagmus, Pain, Palpitations, Photopsia, Tremor, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Retinal disorders (narrow), Vestibular disorders (narrow), Ocular motility disorders (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Peanuts
Diagnostic Lab Data: EKG, chest X-ray, blood work. All results within normal ranges. All done 4/27/21. Blood checked for infection. Result negative. 5/6/21.
CDC Split Type:

Write-up: Gastrointestinal issues including severe nausea, diarrhea, and loose stools. Difficulty eating due to tightness of stomach and feeling full after only a few bites. Sharp chest pains, including racing heartbeat and pressure which induces coughing. Various sharp body pains, mostly in the chest and torso. Uncontrollable shaking, and a buzzing electric feeling throughout body. Flashing in eyes when closed. Head feels heavy with constant vertigo and brain fog. Muscle spasms all over and twitching in left index finger. Insomnia due to listed issues. Nystagmus and feeling of eyes vibrating.


VAERS ID: 1389243 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood test, Computerised tomogram, Dyspnoea, Eye pain, Fatigue, Headache, Inflammation, Oedema peripheral, Pain in extremity, Peripheral swelling, Pruritus, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None stated
Current Illness: None stated
Preexisting Conditions: None stated
Allergies: None stated
Diagnostic Lab Data: Pt. got CAT Scan and blood work during ER visit on 4/21/21 and was diagnosed with foot edemas. 2nd time pt. went to the clinic to f/u she had physical and everything came out normal.
CDC Split Type:

Write-up: Pt. had swelling all over her body starting 4/8/21 at 8:45pm, she had these symptoms for two weeks. Pt went to the ER on 4/21/21 since symptoms did not go away or got better. Pt had a CAT Scan and blood work done during that visit, and she was discharged and was diagnosed with foot edemas. Pt reported having the following symptoms continue after ER visit: inflammation in all of her body, swelling of hands and legs, sharp pain in eyes, toes, and arm, extreme fatigue, at night she has difficulty breathing, itching all over her body, headache, pain in lower calf and ankles of both legs but more severe on left calf.


VAERS ID: 1389246 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-06
Onset:2021-05-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Inflammation, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen right hand and inflamed and painful index tendon sheath. Swollen right foot and painful large toe


VAERS ID: 1389529 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-24
Onset:2021-05-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Skin reaction
SMQs:, Anaphylactic reaction (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: Synthroid, Omeprazole, cyclobenzaprine,
Current Illness: unknown
Preexisting Conditions: respiratory issues, thyroid disorder
Allergies: sodium benzoate, codeine, guaifenesin, macrolides, tetracyclines, pregabalin, sulfa, cephalosporin, penicillin, meperidine, corticosteroids, morphine
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient had a skin reaction possibly from covid vaccine. The following day developed shortness of breath and was sent to the ER


VAERS ID: 1389547 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-08
Onset:2021-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chest pain, Dyschromatopsia, Seizure, Syncope, Ultrasound scan
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Other ischaemic heart disease (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Fainting/ seizure after injection could only see white for 3 hours and extreme chronic chest/ heart pain within 2 hours of having the shot


VAERS ID: 1389562 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-25
Onset:2021-05-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, Cardiac pacemaker insertion, Dizziness, Vaccination complication
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: patient did not provide
CDC Split Type:

Write-up: Patient called 6/10 and stated on 5/27 he started feeling light headed and this continued through 6/1 when he went to the ER where they diagnosed him with a heart condition he was told was due to the vaccine. He had a pacemaker implanted and is now doing well. He gave me no other details.


VAERS ID: 1390323 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium decreased, Blood urea increased, Carbon dioxide decreased, Chest X-ray normal, Chest pain, Computerised tomogram coronary artery normal, Differential white blood cell count, Dyspnoea, Electrocardiogram, Full blood count, Gait disturbance, Haematocrit normal, Haemoglobin decreased, Haemolysis, Headache, Metabolic function test, Platelet count
SMQs:, Acute renal failure (broad), Haemolytic disorders (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81 mg Dapagliflozin 10 mg Gabapentin 100 mg Glyburide-metFORMIN 5 mg 500 mg Insulin glargine (Toujeo Solostar) 15 units Lisinopril 20 mg Metoprolol 50 mg Multivitamin (Super B complex) 1 tab Prescription: Pantoprazole (Protonix 40
Current Illness: n/a
Preexisting Conditions: Diabetes High blood pressure Foot infection
Allergies: n/a
Diagnostic Lab Data: RESULTS [Laboratory List] Basic Metabolic Panel 4/16/21 Hemogram With Platelet Count and Differential 4/15/21Hgb Most recent to oldest [Reference Range]: 1 Hgb [11.4-14.7 g/dL] 11.3 g/dL *LOW*(4/16/21 12:25 AM)Hct Most recent to oldest [Reference Range]: 1 Hct [34.3-45.5 %] 37.6 % (4/16/21 12:25 AM)Sodium Lvl Most recent to oldest [Reference Range]: 1 Sodium Lvl [135-145 mmol/L] 135 mmol/L (4/16/21 4:00 AM)Potassium Lvl Most recent to oldest [Reference Range]: 1 Potassium Lvl [3.5-5.0 mmol/L] 4.9 mmol/L 1(4/16/21 4:00 AM) 1Result Comment: RESULT MAY BE QUESTIONABLE DUE TO SLIGHT HEMOLYSIS Glucose Lvl Most recent to oldest [Reference Range]: 1 Glucose Lvl [70-100 mg/dL] 124 mg/dL *HI*(4/16/21 4:00 AM)BUN Lvl Most recent to oldest [Reference Range]: 1 BUN Lvl [5-25 mg/dL] 28 mg/dL *HI*(4/16/21 4:00 AM)Creatinine Lvl Most recent to oldest [Reference Range]: 1 Creatinine Lvl [0.60-1.20 mg/dL] 1.10 mg/dL (4/16/21 4:00 AM)CO2 Lvl Most recent to oldest [Reference Range]: 1 CO2 Lvl [24-32 mmol/L] 21 mmol/L *LOW*(4/16/21 4:00 AM)Chloride Lvl Most recent to oldest [Reference Range]: 1 Chloride Lvl [98-110 mmol/L] 100 mmol/L (4/16/21 4:00 AM)Orders for Microbiology Reports Name Date Acid Fast Bacteria Culture with Smear 6/8/16 Fungus Culture With Smear 6/8/16 Wound Culture Surgical with Gram Stain 6/8/16 Wound Culture Drainage With Gram Stain 6/7/16 -------------------------------------------------------- Microbiology Reports TEST: AFB Cult w Smear STATUS: Auth (Verified) BODY SITE: SOURCE: Surgical COLLECTED DATE/TIME: 6/8/16 11:50 AM ***Report Status*** FINAL 07/25/2016 TEST: Fungus Cult w Smear STATUS: Auth (Verified) BODY SITE: SOURCE: Surgical COLLECTED DATE/TIME: 6/8/16 11:28 AM ***Report Status*** FINAL 07/05/2016 TEST: Wound Surg Cult w GS STATUS: Auth (Verified) BODY SITE: SOURCE: Surgical COLLECTED DATE/TIME: 6/8/16 11:28 AM ***Report Status*** FINAL 06/13/2016 TEST: Wound Drng Cult w GS STATUS: Auth (Verified) BODY SITE: SOURCE: Other COLLECTED DATE/TIME: 6/7/16 4:33 AM ***Report Status*** FINAL 06/10/2016 -------------------------------------------------- Radiology Reports (Most Recent Ten) 4/16/21 3:27 AM CT Coronary Angio With Contrast; Modified Notes: (CT Coronary Angio With Contrast) Reason For Exam: Coronary Artery Disease, NOS Report EXAM: CT CORONARY ARTERIES INDICATION: Chest pain and dyspnea COMPARISON: 1/2/2018 TECHNIQUE: High resolution axial images were obtained through the level of the heart without intravenous contrast for the purpose of calcium scoring. The patient was injected with iodinated contrast via an upper extremity vein with a saline chaser using a dual injector protocol. Following the bolus, axial images were obtained through the level of the heart. 3D postprocessing with multiplanar reconstructions were performed on a dedicated workstation. Up-to-date CT equipment and radiation dose reduction techniques were employed. ACQUISITION: Retrospective ECG triggering was used. Heart rate at the time of acquisition was approximately 74 bpm. MEDICATIONS: Metoprolol 50 mg by mouth. 0.4 mg sublingual nitroglycerine was administered immediately prior to scanning. TECHNICAL QUALITY: Good, with minor artifact but good diagnostic quality. FINDINGS: CORONARY CALCIUM SCORE AND DISTRIBUTION: Left main: 0 Left anterior descending: 0 Left circumflex: 0 Right coronary artery: 0 Total Agatston score: 0 Percentile Ranking: 25 CORONARY ARTERY EVALUATION: Dominance: The patient is left dominant with diminutive right coronary artery. There are no coronary artery anomalies. Left Main: No plaque or stenosis. Left Anterior Descending: No plaque or stenosis. Left Circumflex: No plaque or stenosis. Right Coronary: No plaque or stenosis. CARDIAC ANATOMY: There is no chamber enlargement or hypertrophy. There is no evidence of hypoperfusion or infarct. There is no pericardial thickening or effusion. CARDIAC INDICES: Ejection fraction: 69% Ventricular end-diastolic volume: 94 mL Ventricular end-systolic volume: 29 mL Stroke volume: 65 mL Myocardial mass: 135 grams EXTRA CARDIAC: Fluid in the esophagus. IMPRESSION: 1. Normal myocardial morphology and function. 2. Normal study of the coronary arteries. 3. Fluid in esophagus, which can be seen in gastroesophageal reflux. CAD-RADS 0: Degree of maximal coronary stenosis - 0% Interpretation - ACS highly unlikely. Management - No further evaluation of ACS is required. Consider other etiologies. ***Final Report*** Addendum The patient received 85 ml Isovue 370. ***Final Report*** Exam Date Time Procedure Performing Provider Status 4/15/21 6:08 PM XR Chest 1 View Notes: (XR Chest 1 View) Reason For Exam: Chest Pain Report EXAM: SINGLE VIEW CHEST INDICATION: Chest pain. COMPARISON: 1/1/2018. VIEWS: 1 FINDINGS: LUNGS/PLEURA: Clear. No effusions. HEART/MEDIASTINUM: No cardiomegaly. No mediastinal or hilar mass. LIFE SUPPORT LINES: None. PNEUMOTHORAX: None. OSSEOUS STRUCTURES: No acute fracture or destructive lesion. SOFT TISSUES: Normal. IMPRESSION: Normal single view chest. ***Final Report*** Exam Date Time Procedure Performing Provider Status 5/21/18 11:49 AM MA Digital Screening Mammo-Bil/CAD Notes: (MA Digital Screening Mammo-Bil/CAD) Reason For Exam: SCREENING Report EXAM: MA DIGITAL SCREENING MAMMO-BIL/CAD INDICATION: Screening. COMPARISON: 2/14/2017 TECHNIQUE: Craniocaudal and mediolateral oblique views of both breasts were obtained. CAD device was utilized in reviewing these images. FINDINGS: The breasts are heterogeneously dense, which may obscure small masses. No dominant masses, tissue distortion, or suspicious calcifications are identified. IMPRESSION: No mammographic evidence of malignancy RECOMMENDED FOLLOWUP: Screening mammogram in 1 year BI-RADS category 1: Negative. ***Final Report*** Exam Date Time Procedure Performing Provider Status 1/2/18 3:26 AM CT Coronary Angio With Contrast Auth (Verified) Notes: (CT Coronary Angio With Contrast) Reason For Exam: Coronary Artery Disease, NOS Report EXAM: CT CORONARY ARTERIES INDICATION: Chest pain, CAD COMPARISON: CXR 1/1/2018 TECHNIQUE: 2.5 mm axial images were obtained through the level of the heart without intravenous contrast for the purpose of calcium scoring. The patient was injected with 100 mL of Omnipaque 350 via an upper extremity vein with a saline chaser using a dual injector protocol. Following the bolus, axial images were obtained through the level of the heart. 3D postprocessing with multiplanar reconstructions were performed on a dedicated workstation. Up-to-date CT equipment and radiation dose reduction techniques were employed. ACQUISITION: Retrospective ECG triggering was used. Heart rate at the time of acquisition was approximately 63-65 bpm. MEDICATIONS: 100 mg of metoprolol by mouth and 40 mg of metoprolol IV. 0.4 mg sublingual nitroglycerine was administered immediately prior to scanning. TECHNICAL QUALITY: Acceptable, with moderate artifacts. FINDINGS: CORONARY CALCIUM SCORE AND DISTRIBUTION: Left main: 0 Left anterior descending: 0 Left circumflex: 0 Right coronary artery: 0 Total Agatston score: 0 Percentile Ranking: 0 CORONARY ARTERY EVALUATION: Dominance: The patient is left dominant. There are no coronary artery anomalies. Left Main: No plaque or stenosis. Left Anterior Descending: No plaque or stenosis. Left Circumflex: No plaque or stenosis. Right Coronary: Diminutive. No plaque or stenosis. CARDIAC ANATOMY: There is no chamber enlargement or hypertrophy. There is no evidence of hypoperfusion or infarct. There is no pericardial thickening or effusion. CARDIAC INDICES: Ventricular end-diastolic volume: 88.91 mL Ventricular end-systolic volume: 24.71 mL Stroke volume: 64.2 mL Ejection fraction: 72.21% Myocardial mass: 119.37 grams EXTRA CARDIAC: There are no significant extra-cardiac findings in the available limited views of the lungs and mediastinum. IMPRESSION: 1. Normal myocardial morphology and function. 2. Normal study of the coronary arteries. 3. No significant extra-cardiac findings. CAD-RADS 0: Degree of maximal coronary stenosis - 0% Interpretation - ACS highly unlikely. Management - No further evaluation of ACS is required. Consider other etiologies. ***Final Report*** Exam Date Time Procedure Performing Provider Status 1/1/18 4:26 PM XR Chest 1 View, Portable Auth (Verified) Notes: (XR Chest 1 View, Portable) Reason For Exam: Chest Pain Report EXAM: PORTABLE SINGLE VIEW CHEST INDICATION: Chest pain COMPARISON: None VIEWS: 1 FINDINGS: LUNGS/PLEURA: Mild hypoventilatory changes. No effusions. No consolidations. HEART/MEDIASTINUM: Mild cardiomegaly. No mediastinal or hilar mass. LIFE SUPPORT LINES: None. PNEUMOTHORAX: None. OSSEOUS STRUCTURES: No acute fracture or destructive lesion. IMPRESSION: Mild cardiomegaly with hypoventilatory changes. ***Final Report** Exam Date Time Procedure Performing Provider Status 10/28/17 7:22 PM XR Spine Lumbosacral 2 or 3 View Auth (Verified) Notes: (XR Spine Lumbosacral 2 or 3 Views) Reason For Exam: Trauma Report EXAM: LUMBAR SPINE INDICATION: Trauma COMPARISON: No priors VIEWS: 3 FINDINGS: BONE DENSITY: Normal mineralization. VERTEBRAL BODIES: Subtle buckling along the anterior aspect of the L2 vertebral body which may represent a compression fracture. DISK SPACES: Disk space height preserved. ALIGNMENT: No listhesis or scoliosis. JOINT SPACES: Well preserved. No erosion. IMPRESSION: Minimal buckling along the anterior aspect of the mid L2 vertebral body which may represent a compression fracture. Correlate for focal tenderness and if clinically indicated consider CT or MRI of the lumbar spine. Exam Date Time Procedure Performing Provider Status 10/28/17 7:22 PM XR Shoulder Complete Right Notes: (XR Shoulder Complete Right) Reason For Exam: Trauma Report EXAM: RIGHT SHOULDER INDICATION: Trauma COMPARISON: No prior comparison VIEWS: 3 FINDINGS: BONE DENSITY: Normal. JOINT SPACES: Well preserved, no erosions. FRACTURE: Chronic, healed fracture deformity of the distal 1/3 right clavicle. Os acromiale. DISLOCATION: None. SOFT TISSUES: No mass. IMPRESSION: 1. Chronic, healed fracture deformity of the distal 1/3 right clavicle. 2. Os acromiale. This can predispose the patient to subacromial impingement. Exam Date Time Procedure Performing Provider Status 10/28/17 7:22 PM XR Hip Bilateral w/Pelvis Notes: (XR Hip Bilateral w/Pelvis) Reason For Exam: Trauma Report EXAM: PELVIS AND BOTH HIPS INDICATION: Trauma COMPARISON: No prior comparison VIEWS: 3 FINDINGS: BONE DENSITY: Normal. JOINT SPACES: Well preserved, no erosions. FRACTURE: None. DISLOCATION: None. SOFT TISSUES: Calcified atherosclerotic disease. IMPRESSION: No acute osseous or soft tissue abnormality Exam Date Time Procedure Performing Provider Status 10/28/17 7:44 PM CT Abdomen/Pelvis w/o Contrast Notes: (CT Abdomen/Pelvis w/o Contrast) Reason For Exam: Flank Pain, Renal Protocol;Other Report EXAM: CT ABDOMEN AND PELVIS WITHOUT IV CONTRAST INDICATION: Trauma COMPARISON: None TECHNIQUE: Contiguous axial images were obtained from the lung bases to the pelvic floor without intravenous or oral contrast. Coronal and sagittal reformations are provided. Up-to-date CT equipment and radiation dose reduction techniques were employed. FINDINGS: LUNG BASES: Clear. LIVER: No mass. No intrahepatic biliary dilatation. GALLBLADDER: No wall thickening. No stones. COMMON BILE DUCT: Normal caliber. No stones. SPLEEN: Within normal limits. PANCREAS: No mass. No pancreatic fluid collections. ADRENALS: No masses. KIDNEYS: No masses. No hydronephrosis. No nephrolithiasis. LYMPH NODES: No adenopathy. STOMACH, SMALL BOWEL AND COLON: No bowel wall thickening or obstruction. Appendix is normal. PERITONEAL CAVITY: No mesenteric stranding or free fluid. OSSEOUS STRUCTURES: No acute fracture or destructive lesion. ABDOMINAL AORTA: No aneurysm. PELVIC ORGANS: Normal. IMPRESSION: Normal CT abdomen and pelvis.2/14/17 11:32 AM MA Digital Screening Mammo-Bil/CAD. Notes: (MA Digital Screening Mammo-Bil/CAD) Reason For Exam: FC - Encounter for other screening for malignant neoplasm of breast. Report. EXAM: MA DIGITAL SCREENING MAMMO-BIL/CAD INDICATION: Screening. COMPARISON: None, TECHNIQUE: Craniocaudal and mediolateral oblique views of both breasts were obtained. CAD device was utilized in reviewing these films. FINDINGS: The breasts are heterogeneously dense, which may obscure small masses. No masses, suspicious microcalcifications or secondary signs of malignancy are identified. IMPRESSION: No mammographic evidence of malignancy. RECOMMENDED FOLLOWUP: Screening mammogram in one year. BI-RADS category 1: Negative.
CDC Split Type:

Write-up: Headache Chest pain Difficulty walking Shortness of breath Abnormal heart rhythm


VAERS ID: 1390357 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Cardiac monitoring normal, Chills, Computerised tomogram normal, Dizziness, Dysphagia, Fatigue, Feeling abnormal, Feeling cold, Glossitis, Headache, Hyperhidrosis, Hyperventilation, Hypoaesthesia, Hypoaesthesia oral, Influenza like illness, Injection site pain, Magnetic resonance imaging head normal, Musculoskeletal stiffness, Oropharyngeal pain, Pain, Palpitations, Paraesthesia, Pyrexia, Speech disorder, Tension, Thirst, Vision blurred
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (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), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (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: All test results from the 2 ER visits were normal, including the CT scan. A brain MRI, done on 5/5, was also normal. A 24-hour heart monitor (06/03/2021) also had normal results. Waiting to see a neurologists at the end of September (soonest available so far).
CDC Split Type:

Write-up: About ten minutes after leaving the vaccination site, I began feeling a strange dizziness; an internal wobbly-Jello-like sensation. I felt a pin/needle/ stabbing sensation on my left fingers, particularly on the dorsal side of the third and fourth fingers, and in the middle of the tongue. The tongue felt as if was receiving a subtle electric charge that immobilized it with every shock. It lasted about 5 minutes. My vision was blurry. After that, my mind was foggy. At about midnight, flu-like symptoms began sudden, but they were the expected symptoms for a covid vaccine (fever, body aches, sweats, sore throat, severe headache, pain on injection site, etc.) However, the pin/needle/ stabbing sensation was felt throughout the body. It sometimes felt as if a bubble, waves, or something was moving inside of me, in different areas of the body (rib cage, legs, chest, arms, legs, face, and top of the head (like when a baby moves inside of a pregnant woman, without the visible bump). My body, head, and neck felt stiff. Symptoms were milder after 48 hours, on and off, until 4/13/2021 when I felt a sunken feeling, like something dropped inside of me (sugar, blood pressure, blood rush, I do not know). The tense feeling of the body returned. I felt dizzy. Left arm and leg felt tingly. There were palpitations, but I think that it was due to being scared about all the other symptoms. I felt cold and was shivering. The head felt stiff again. I was very thirsty. In the following days, symptoms got milder. On 4/22/2021, at about 4pm, the sunken feeling returned, along with the dizziness, wave or bubble-like sensation through head, face, body. The wave-like sensation flashed across my face, head, and neck intermittently. It was hard to speak, pronounce words, and swallow. The tongue felt numb. It lasted about two hours. I felt exhausted, so I took a nap until 8pm. When I woke up, I felt like nothing had happened, no symptoms until 1:00 am. At 1:00 pm, 4/23/2021, the sunken feeling, dizziness, palpitations, heavy breathing without shortness of breath, cold/shiver, blurred vision, the wave-like sensation, and pokes suddenly returned. The waves were more intense and felt like pressure on the right side of the head and left side of the chest. Went to the Emergency Room. With every wave of sensations, was accompanied by an urgency to urinate. I urinated like 3 times in a span of 30 to 45 minutes (full bladder). Findings were normal but symptoms continued through 4/24/2021, on and off. Each episode lasts anywhere from 1 to 4 hours. Short lasting, mild symptoms returned Monday 04/26/2021, at night, until Wednesday 04/27. However, that Wednesday night, I felt a belt like, tight sensation around the left bicep and neck. It felt as if I was being grabbed by the left arm. On 4/29/2021, around 5:00 pm, I called an ambulance because all symptoms had returned ?full force?, such as sunken feeling, blurred vision, dizziness (like passing out), intense head and left chest pressure (in waves, like having a huge fish or parasite inside the chest and head), numb mouth (like dental anesthesia), hard to speak (hard time sending the message from brain to mouth). It took great effort to speak and felt that I had to decide whether continue speaking or staying conscious. I also had blurred vision with the first sunken feeling. Symptoms continued 2 to 3 times a day. Since 4/29 a feeling of being inside of an elevator, airplane, or earthquake, and the numbness on the left side of chest and arm remain, even when no other symptoms are present. Also, both arms become numb while sleeping, every night, multiple times a night, since 4/29. Since then, I sleep on 3 pillows (two in my head, one on the shoulders to create an angle) to minimize the numbness of the arms and the head/neck pressure while sleeping. On 5/5/21, symptoms began while car riding as a passenger and upper body felt tight. Strangely, symptoms ended when car stopped moving. Later that day, while walking through a department store, nostrils felt uneven, as if the left nostil were breathing cold air while the right was taking warm air. That night, symptoms intensified (the attack). Like all other times, urinating was too frequent while ?the attack? is present. This time, my body felt sore and tired (Flu-like). There was an intense pressure on the right side of the eye and forehead. The neck stiffness was intense. For the past two weeks, ?attacks? have been less frequent, about 2 to 3 times a week, lasting a maximum of 2 hours. The numbness on the left side of the chest and arm continues. The feeling of something moving or pins/needles may appear sporadically throughout the day. At times, they feel like twitches. The woozy feeling of being inside of an elevator remains. Breathing still feels heavy, like trying to breathe with the face in front of a fan. All test results from the 2 ER visits were normal, including the CT scan. A brain MRI, done on 5/5, was also normal. A 24-hour heart monitor also had normal results.


VAERS ID: 1390688 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A 21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Face oedema, Hypersensitivity, Hypotension, Hypoxia, Nausea, Oxygen saturation decreased, Pharyngeal oedema, Tongue oedema, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: THC DROPS STENOCARE
Current Illness: Alcoholic (rarely about two (2) drinks per month.); Allergy to antibiotic (Allergic to cipro, doxycycline, flagyl and cephalosporins); Antihemophilic factor; Arthritis; Asthma; Endometriosis; Non-smoker; Penicillin allergy (Allergy to penicillin, amoxicillin.); Post-traumatic stress disorder; Slipping rib syndrome; Vesicoureteral reflux with reflux nephropathy, bilateral
Preexisting Conditions: Medical History/Concurrent Conditions: Food allergy (Allergic to tree nuts, almonds, peanuts and legumes.); Comments: No illicit drug use or drug abuse.
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: Oxygen saturation low; Result Unstructured Data: 92%, 92%; Test Date: 20210604; Test Name: Blood pressure; Result Unstructured Data: 62/80, 62/80
CDC Split Type: USJNJFOC20210611762

Write-up: OXYGEN WAS AT 92%; BLOOD PRESSURE 62/80; EDEMA OF FACE; EDEMA OF THROAT; EDEMA OF TONGUE; EMESIS; WHEEZING; ALLERGIC REACTION; NAUSEA; This spontaneous report received from a patient concerned a 23-year-old white, Not-Hispanic/ Latino female. The patient''s weight was 230 pounds, and height was 64 inches. The patient''s concurrent conditions included non-smoker, alcoholic, penicillin allergy, anti-biotic allergy, food allergy, factor VIII (a), endometriosis, bilateral urinary reflex, arthritis, slipping rib syndrome, asthma, and PTSD (Post-traumatic Stress Disorder), and other pre-existing medical conditions included no illicit drug use or drug abuse. The patient was previously treated with Leuprorelin acetate for 10 years which was ended on FEB-2020 and 2 rounds of Intravenous chemotherapy for 6 months apart ending 22-NOV-2019, for drug used for unknown indication; and experienced drug allergy when treated with acetylsalicylic acid, gabapentin, ethinylestradiol/ferrous fumarate/norethisterone acetate, meloxicam, ibuprofen, paroxetine hydrochloride, topiramate, ketorolac tromethamine, venlafaxine, and sertraline hydrochloride for drug used for unknown indication. The patient mentioned that she had also taken 2 oral chemotherapy drugs of which names she did not remembered. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 202A 21A and expiry: 23-JUN-2021) dose was not reported, frequency of 1 total, administered on 04-JUN-2021 18:10 for prophylactic vaccination on right deltoid. Concomitant medications included cannabis sativa flower for arthritis. The patient reported that after vaccination on 04-JUN-2021 at 18:15 she began experiencing allergic reactions with symptoms of nausea, vomiting, wheezing, and swelling of face, throat and tongue. She also mentioned that her oxygen was at 92% and blood pressure was 62/80. Laboratory data included: Blood pressure (NR: not provided) 62/80 62/80, and Oxygen saturation low (NR: not provided) 92% 92%. On 04-JUN-2021 18:20, treatment medications included: epinephrine. On 04-JUN-2021 18:20, treatment medications included: Epinephrine, 2 doses had been administered. The patient had visited the emergency department for monitoring. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from oxygen was at 92%, blood pressure 62/80, emesis, and nausea on 04-JUN-2021, was recovering from wheezing, edema of face, edema of throat, and edema of tongue, and the outcome of allergic reaction was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: 20210611762-COVID-19 VACCINE AD26.COV2.S-OXYGEN WAS 92%,BLOOD PRESSURE 62/80,EDEMA OF FACE,EDEMA OF THROAT,EDEMA OF TONGUE,EMESIS,WHEEZING. 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).20210611762-COVID-19 VACCINE AD26.COV2.S-ALLERGIC REACTION,NAUSEA. This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1391387 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-29
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Full blood count abnormal, Haemorrhage, Immune thrombocytopenia, Menstrual disorder, Platelet count decreased
SMQs:, Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lexipro
Current Illness: none
Preexisting Conditions: none
Allergies: shellfish
Diagnostic Lab Data: CBC panel revealed 7,000 platelet level at ER on June 2 2021
CDC Split Type:

Write-up: I developed ITP and was hospitalized June 2-4 to stabilize my platelet numbers after hemorrhaging on my period for the second month in a row.


VAERS ID: 1391517 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-15
Onset:2021-03-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pneumonia vaccine
Other Medications: Pravastatin, Losartan, Co q 10, Fish oil, Daily vitamin, and green tea.
Current Illness: none
Preexisting Conditions: Pace maker, bradycardia, and managed high blood pressure
Allergies: Airborne allergy, pollen, chemical fragrances, pneumonia vaccine, erythromycin, sulfur drugs, and licorice
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Two weeks after the vaccine on March 29,2021 all day that day right arm was stiff and felt like every nerve in her body was in pain. stated she felt like somebody was ripping her arm off it. Tried taking extra strength acetaminophen but it still didn''t work. Range of motion with moving her arm didn''t bother her at all it was just pain in her arm.


VAERS ID: 1391630 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-05-20
Onset:2021-05-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Chest X-ray abnormal, Death, Intensive care, Metabolic function test, Microbiology test, Pneumonia, Rhabdomyolysis, SARS-CoV-2 test, Sepsis, Sputum culture
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), Neuroleptic malignant syndrome (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), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-05-24
   Days after onset: 1
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: meclizine zyrtec azithromycin
Current Illness: Time of hospitalization Severe sepsis, bilateral pneumonia, acute kidney injury, rhabdo
Preexisting Conditions: hyperlipidemia AFIB Tumor in lungs
Allergies: penicillin sulfa drugs
Diagnostic Lab Data: CMP, microbiology, chest xray, sputum culture, covid test-all done on 5/23/21 and 05/24/21
CDC Split Type:

Write-up: 3 days after vaccination, patient was found down in his home. Admitted to ICU from the ER with severe sepsis, bilateral pneumonia, acute kidney injury and rhabdomyolysis. Patient deceased day after hospitalization.


VAERS ID: 1391681 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-27
Onset:2021-06-09
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aneurysm, Cerebral haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: brain bleed/aneurysm


VAERS ID: 1391771 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203AZLA / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications: Vitamin D, Vitamin C, Vitamin E, Restasis, Benicar, Keppra
Current Illness: I had no illnesses at the time of vaccination.
Preexisting Conditions: I have Lymphoma and Arthritis.
Allergies: I am allergic to shellfish, sulfur, and latex.
Diagnostic Lab Data: I had blood drawn. No know results.
CDC Split Type: vsafe

Write-up: I passed out and fell and had a wound on my head.


VAERS ID: 1391773 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-29
Onset:2021-04-20
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: 4/20/2021 EKG administered. I was told I had paracarditis. They gave me a shot of something (anti-inflammatory I believe), which relieved symptoms.
CDC Split Type:

Write-up: Diagnosed with paracarditis after going to emergency room.


VAERS ID: 1391822 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK AR / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cough, Dyspnoea, Heart rate increased, Malaise, Pneumonia, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin for tooth
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Shellfish
Diagnostic Lab Data: Unknown - Care provided at Hospital, - Length of hospital stay unknown. Form requires number of days hospitalized. Indicated 1 in order to be able to submit the report.
CDC Split Type:

Write-up: Patient did not feel well after receiving vaccination. Indicated that she developed a cough, shortness of breath and increased respirations and pulse. She admitted to the hospital on 6/8/21 and was diagnosed with pneumonia.


VAERS ID: 1391917 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Computerised tomogram thorax, Full blood count, Peripheral swelling, Pulmonary embolism
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine, hctz, losartan, ppi
Current Illness:
Preexisting Conditions: htn
Allergies: lisinopril
Diagnostic Lab Data: chest ct, cbc
CDC Split Type:

Write-up: the day after vaccine patient w left leg swelling- 4 days later diagnosed with pulmonary embolus.


VAERS ID: 1391940 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-10
Onset:2021-06-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Hypertension, Hypoaesthesia, Hypoaesthesia eye, Hypoaesthesia oral, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Corneal disorders (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Pt received her vaccine at 1:18pm in RD, at 1:32pm Pt notified RN that she had numbness in her mouth, back of the tongue, and periorbital. She then reported a tingling sensation. Staff monitored & Paramedic assessed VS & noted that she was hypertensive. She requested a juice & drank without difficulty. Shortly after, around 1:55pm, she reported arm numbness bilaterally. AMR was summoned & the Paramedic continued to monitor (1:56pm). AMR arrived at 2:12pm & left with the patient at 2:18pm. She reported global numbness & tingling to AMR staff as she was leaving via gurney with them.


VAERS ID: 1392026 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-06-08
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A - / -

Administered by: Public       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio increased, Aspartate aminotransferase increased, Basophil count normal, Basophil percentage increased, Bilirubin urine, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium increased, Blood chloride increased, Blood creatinine increased, Blood glucose normal, Blood potassium increased, Blood pressure increased, Blood sodium normal, Blood test, Blood urea normal, Blood urine absent, Carbon dioxide increased, Chromaturia, Culture urine, Differential white blood cell count, Eosinophil count normal, Eosinophil percentage increased, Facial paresis, Full blood count, Glomerular filtration rate decreased, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Hemiparesis, Immature granulocyte count, International normalised ratio normal, Lymphocyte count, Lymphocyte percentage increased, Mean cell haemoglobin, Mean cell haemoglobin concentration normal, Mean cell volume normal, Mean platelet volume increased, Metabolic function test, Monocyte count, Monocyte percentage increased, Neutrophil count, Neutrophil percentage increased, Nitrite urine absent, Platelet count normal, Protein total normal, Protein urine absent, Prothrombin time prolonged, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width, Red cell distribution width normal, Specific gravity urine normal, Troponin I increased, Upper motor neurone lesion, Urine analysis abnormal, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine increased, White blood cell count normal, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? albuterol (PROVENTIL, VENTOLIN) 108 (90 BASE) MCG/ACT inhaler, Inhale 2 Puffs by mouth every 6 hours as needed for Wheezing, Disp: 1 Inhaler, Rfl: 11 ? aspirin 81 MG chewable tablet, Take 1 Tab by mouth
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CBC W AUTO DIFF Collection Time: 06/08/21 12:37 PM Result Value Ref Range White Blood Cell Count 7.5 4.8 - 9.6 THOUS/uL Red Blood Cell Count 4.55 4.33 - 5.59 MIL/uL Hemoglobin 14.1 13.1 - 16.8 GM/DL Hematocrit 44.0 38.8 - 49.0 % Mean Corpuscular Volume 96.7 (H) 82.7 - 94.4 FL Mean Corpuscular Hemoglobin 31.0 27.7 - 32.6 PG Mean Corpuscular Hemoglobin Conc 32.0 (L) 32.4 - 35.7 G/DL Rdwcv 14.0 (H) 11.6 - 13.9 % Rdwsd 50.4 (H) 36.0 - 46.1 FL Platelet Count 135 (L) 154 - 364 THOUS/uL Mean Platelet Volume 9.8 8.7 - 11.7 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 72.9 (H) 34.0 - 67.9 % Lymphs 18.2 (L) 19.1 - 41.2 % Monocytes 7.1 6.1 - 12.3 % Eos 1.1 0.9 - 7.6 % Basos 0.3 0.2 - 1.5 % Neutrophils Absolute Count 5.4 2.7 - 5.8 THOUS/uL Lymphocytes Absolute Count 1.4 1.1 - 3.3 THOUS/uL Monocytes Absolute Count 0.5 0.4 - 0.9 THOUS/uL Eosinophils Absolute Count 0.1 0.1 - 0.6 THOUS/uL Basophils Absolute Count 0.0 0.0 - 0.1 THOUS/uL Imm Gran 0.4 0.2 - 0.9 % Abs Imm Gran 0.03 0.0 - 0.1 THOUS/uL COMPREHENSIVE METABOLIC PANEL Collection Time: 06/08/21 12:37 PM Result Value Ref Range Glucose 163 (H) 65 - 100 MG/DL Blood Urea Nitrogen 18 7 - 18 MG/DL Creatinine 1.2 0.7 - 1.3 MG/DL Sodium 144 136 - 145 MMOL/L Potassium 4.1 3.5 - 5.1 MMOL/L Chloride 106 98 - 107 MMOL/L Co2 30 21 - 32 MMOL/L Calcium 9.1 8.5 - 10.1 MG/DL Protein Total 7.4 6.4 - 8.2 G/DL Albumin 3.9 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 95 46 - 116 U/L Alt (SGPT) 23 16 - 63 U/L AST(SGOT) 18 15 - 37 U/L Bilirubin, Total 1.7 (H) 0.2 - 1.0 MG/DL GFR Comment Est GFR 58 (L) $g90 ML/MIN/1.73sq.m PROTIME (PROTHROMBIN TIME) Collection Time: 06/08/21 12:37 PM Result Value Ref Range PROTIME 14.5 (H) 10.3 - 12.6 SEC INR 1.2 (H) 0.9 - 1.1 TROPONIN Collection Time: 06/08/21 12:37 PM Result Value Ref Range Troponin I 0.00 0.00 - 0.06 ng/mL URINALYSIS WITH REFLEX TO CULTURE, IF INDICATED Collection Time: 06/08/21 1:26 PM Specimen: URINE,CATH INDWELLING Result Value Ref Range Glucose UA NEGATIVE NEGATIVE MG/DL Protein UA 1+ (A) NEGATIVE MG/DL Bilirubin UA NEGATIVE NEGATIVE Urobilinogen UA 1.0 0.2 - 1.0 MG/DL pH UA 7.0 5.0 - 8.0 Blood UA 1+ (A) NEGATIVE Ketones UA NEGATIVE NEGATIVE MG/DL Nitrite UA NEGATIVE NEGATIVE Leukocyte Esterase UA 1+ (A) NEGATIVE UR Appearance SLIGHTLY CLOUDY (A) CLEAR Specific Gravity UA 1.020 1.000 - 1.030 Color DARK YELLOW (A) YELLOW Site CATH, IN AND OUT Comment, Urine Culture IN PROGRESS RBC Urine 6 to 10 <3 /HPF WBC Urine 11 to 20 <5 /HPF Bacteria MODERATE (A) NONE /HPF URINE CULTURE Collection Time: 06/08/21 1:26 PM Specimen: URINE,CLEAN CATCH (CCMS) Result Value Ref Range Specimen Type CCMS Special Handling NONE Reflexed from T67684 Culture Result PENDING Specimen Status Report PENDING
CDC Split Type:

Write-up: 76 y.o. male who presents with complaint of right-sided weakness facial droop. Time of onset unknown. Patient has right arm drift, able to raise the right leg against gravity but not against resistance right facial droop. Patient is alert and able to answer questions. Blood pressure is elevated 205/115


VAERS ID: 1392077 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20JA21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Decreased appetite, Diarrhoea, Fatigue, Hyperhidrosis, Impaired work ability, Injection site erythema, Injection site pain, Injection site pruritus, Joint stiffness, Lymphadenopathy, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Kirkland brand multi-vitamin gummies
Current Illness: None known
Preexisting Conditions: chronic lymphocytic leukemia, not treated, only monitored at this time
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Over the course of 10 days following the injection I had fever spikes (up to 102), fatigue, loss of appetite, muscle soreness and joint stiffness (more than normal), chills, sweating, heaviness in chest, diarrhea, I vomitted the day after, but that was just for a period of 4 hours. On the 4th day I woke up with stiffness in my left arm and underarm, and swollen glands. I went to the urgent care on the following morning, but the stiffness and swelling had started to retreat and has since disappeared. Soreness at the injection site for about two weeks after vaccine. It is still a bit tender to the touch, but does not bother me unless rubbed hard. There was also redness and tenderness and some itching at the injection site. I felt poorly enough (the fatigue, mostly), that I was not able to work for 10 days. At about the two week mark I finally had the feeling that I felt good! I occasionally feel fatigued, but have been able to resume normal activities.


VAERS ID: 1392108 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Abscess, Erythema, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications: Levothyroxine 200mcg, prenatal vitamins, birth control pills
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: Pineapple
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swelling, redness, tender, absess, warm to touch


VAERS ID: 1392455 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT FELT DIZZY, FAINTED AND BECAME UNCONCIOUS (FOR ABOUT 1 MINUTE). WE THEN CALLED 911 AND PATIENT WENT TO ER. SHE STAYED FOR SEVERAL HOURS AND RECEIVED HEADACHE MEDICATION AND IV FLUIDS.


VAERS ID: 1392560 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-05-06
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042421A / 1 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bicytopenia, Differential white blood cell count normal, Full blood count normal, Gastrointestinal arteriovenous malformation, Gastrointestinal haemorrhage, Haemorrhagic disorder, Platelet disorder, Platelet factor 4 increased
SMQs:, Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic thrombocytopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Congenital, familial and genetic disorders (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Myelodysplastic syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: high cholesterol, HTN, and hypothyroidism
Preexisting Conditions: high cholesterol, HTN, hypothyroidism
Allergies: NKDA
Diagnostic Lab Data: 4/7/2021 normal CBC with differential 4/8/2021 vaccine 5/6/2021- present continued bicytopenia despite resolution of active GIB
CDC Split Type:

Write-up: 4/7/2021 patient had a normal cbc with differential. on 4/8/2021 she received the J&J vaccine. On 5/6 and 5/25 she was hospitalized with GIB secondary to AVMs. However, from a hematology perspective she has bicytopenia. Further workup as outpatient determines she has continued bleeding issues, clumped platelets, elevated platelet factor analysis. We are going to do a bone marrow biopsy.


VAERS ID: 1392568 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Headache, Influenza like illness, Myalgia, Nausea, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (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: omeprazole, vitamins, oregano, biotin
Current Illness:
Preexisting Conditions: asthma, anemic
Allergies: penicillin
Diagnostic Lab Data: yes
CDC Split Type:

Write-up: flu like feeling, chest pains, muscle pain, nauseous, tingling sensations in feet and legs, headache, shortness of breath


VAERS ID: 1392587 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Blood test, Chest pain, Dyspnoea, Electrocardiogram, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Esomeprosol, Lisinopril, Atorvastatin, Vitamins C&D, Zinc, Baby aspirin
Current Illness:
Preexisting Conditions: Cluster headaches, GERD (Barret;s syndrom)
Allergies: None
Diagnostic Lab Data: EKG, CT scan of arteries, blood work (routine and looking for clots).
CDC Split Type:

Write-up: Shortness of breath and chest pains after routine workout at the gym. Got worse thru the day. Went to ER in the evening. Tests for heart attack and blood clots were negative. Sent me home next morning feeling slightly better. Next night (6/2) woke up at 3 am with shooting pains in right leg below knee. Back to ER where they repeated heart tests and did sonogram of leg. All normal. Sent me home again. Symptoms continue to this day with slight improvement. Have follow ups scheduled with Cardio and Pulmonary.


VAERS ID: 1392675 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-05-20
Onset:2021-05-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood test, Computerised tomogram, Electrocardiogram, Electroencephalogram, Fatigue, Headache, Magnetic resonance imaging, Migraine, Road traffic accident, Seizure, Tinnitus, Venogram, Vision blurred
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: I was taking no medications during the time of vaccination.
Current Illness: No, none.
Preexisting Conditions: No, none.
Allergies: No, none.
Diagnostic Lab Data: CAT scan, MRI, MRV, EKG, EEG, Blood work.
CDC Split Type:

Write-up: After receiving Janssen vaccine, I experienced feelings of fatigue, ringing in ears, blurry vision, migraine type headaches. I had not suffered from any of these symptoms prior to the vaccine. On 6/2/21, I was feeling similar symptoms, and particularly a severe headache and some fatigue. I was driving to the gym, to see if perhaps, doing a little walking or exercising may make me feel better, when I experienced a seizure while driving, lost control of vehicle and ended up, off the road and hit a tree, I do not remember anything from the crash. I awoke in an ambulance, and was taken by helicopter to Hospital. I received emergency care and was admitted to the hospital.


VAERS ID: 1392755 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-06-04
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Nasal congestion, Oropharyngeal pain, Paranasal sinus discomfort, Respiratory tract congestion, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diffuse large B cell lymphoma- in remission
Allergies: NKA
Diagnostic Lab Data: SARS-COV-2 Rapid: SARS-COV-2 detected (6/4/2021)
CDC Split Type:

Write-up: 62 YO female presents to the ED on 6/4 with complaints of non productive cough, chest congestion, post-nasal drip, nasal congestion, chills, SOB, sinus pressure, and sore throat. Denies fever. COVID rapid test results back negative the same day. Vitals were stable and pt was discharged with COVID-19 diagnosis. She is s/p J&J vaccination on 5/11.


VAERS ID: 1392767 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-30
Onset:2021-05-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Full blood count normal, Headache, Metabolic function test normal, Monocyte count increased
SMQs:, Dementia (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: Flu vaccine in 2019 - fever, chills, vomiting the next day
Other Medications: daily vitamin, calcium, B12, probiotics
Current Illness: none
Preexisting Conditions: celiacs
Allergies: gluten (celiacs), bactram, eggplant
Diagnostic Lab Data: basic metabolic panel, CBC and differential. Everything was in the normal range, except MONOS was 11.2
CDC Split Type:

Write-up: I started getting headaches, which is highly unusual because I NEVER get headaches. Typically I get a headache every 5 years or less, and usually only if my nose is completely stuffed up with a cold. The headache started on Wed night and kind of came and went, but even when it was gone I just didn''t feel right. No other cold symptoms, just headache and some fatigue. On Friday I made the vaers report (I think) and contacted my PCP and she did not have any available openings for me to come in so she referred me to walk in clinic. They said they couldn''t do anything, and told me to keep monitoring it, and if it persisted to go to the emergency room. On Sunday evening I was still having the headaches so I went to the ER. They did some blood tests, everything was normal, so I left. On Monday I was talking with a friend about what happened, and she said she was having headaches too, but she knew hers were from lilacs which she has been allergic to for many years. I have never been allergic to lilacs or any flowers, but I did have a spray of lilacs in my house and when I thought about it I realized that the headaches started the same night that I brought home the lilacs. So I got rid of the lilacs and the headaches stopped. So the headaches were not directly due to the vaccine, but I am wondering if the vaccine made me more sensitive to allergens??


VAERS ID: 1392958 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-12
Onset:2021-04-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / N/A UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Brain scan normal, Headache, Magnetic resonance imaging head normal, Nausea, Paraesthesia, Photophobia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal 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: Excedrin , ibuprofen as needed
Current Illness:
Preexisting Conditions: migraines
Allergies: none
Diagnostic Lab Data: Brain MRA and MRI---no cause of headache found.
CDC Split Type:

Write-up: Right sided headache x 5 days. No thunderclap onset. Patient complains of nausea and sensitivity to light. Headache is throbbing in nature. Patient experienced tingling in right cheek the day before presentation. Patient is treated with diphenhydramine and prochlorperazine in ER and is given a prescription for Topamax to take at home for the next 5 days.


VAERS ID: 1392961 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-11
Onset:2021-06-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Malaise
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: N/A. Paramedics completed examination.
CDC Split Type:

Write-up: Almost immediately (within 15 seconds) after administration, patient stated she did not feel well. Soon after, stated she was going to vomit, requested water, stated "I''m going to die", leaned head back once and full body forward 2 times in chair and almost(or did for a moment?) pass out seated, requested and tried to roll out of chair to floor. Pharmacist was resting arm on patient shoulder to stop potential fall, changed position to front of patient, then assisted to the floor (~2:15-2:19pm). Patient continued drinking and completed ~4oz of water while changing position from back to right side. Rolled up smocks were under her head and neck for comfort. Pharmacist and supervisor continued to ask questions which were answered correctly and she was able to grasp pharmacist''s hand and squeeze with both of her hands. Patient stated this is reason she does not donate blood and ''?'' and ginger have helped her in the past. She stated she was feeling better and sat up against the wall. When informed that paramedics were coming to assess. She stated no need and requested water and snack, stating possible that lack of food or water and being in the warehouse for awhile may have contributed. Water and snack were denied to patient upon medical dispatch request. Patient brought herself back to lying on right side until paramedics arrived.


VAERS ID: 1392988 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-30
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Blood albumin decreased, Blood thyroid stimulating hormone normal, Borrelia test, Dysphonia, Enlarged uvula, Face oedema, Fatigue, Haematocrit increased, Haemoglobin normal, Oedema peripheral, Penile oedema, Pharyngitis, Protein urine, Scrotal oedema, Thyroxine free normal, Ultrasound Doppler normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Angioedema (narrow), Parkinson-like events (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Proteinuria (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 6/3/21: H/H 18.4/54, TSH 6.22, FT4 1.2, lyme pending, UA protein, albumin 1.9
CDC Split Type:

Write-up: Initially seen on 5/30 for pharyngitis x6 days, swollen uvula, LE edema. Given dose of dexamethasone. Seen again on 6/3 for $g1 week LE edema, fatigue, penile and scrotal edema. Labs showed H/H and platelets slightly elevated. TSH also very high. Went to outside ED on 6/5 and had negative DVT U/S. Seen again on 6/9 at our clinic with significant facial edema, increased uvula swelling, changes in voice quality, abdominal bloating, and persistent LE edema. Given prednisone course and referred back to ED for airway evaluation and further evaluation/mgmt.


VAERS ID: 1393231 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-28
Onset:2021-06-03
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial flutter, Blood test, Cardiac ablation, Chills, Electrocardiogram, Heart rate increased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Baclofen, Testosterone, rosuvastatin, multivitamin, turmeric
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Cardiac ablation performed May 24, 2021 to address atrial flutter EKGs blood work rapid heart rate (166 beats per minute) vs. normal rate of 55 beats per minute
CDC Split Type:

Write-up: Severe immune system response. High fever, chills, aches. Set off atrial flutter and was admitted to emergency room/hospital for cardiac ablation


VAERS ID: 1393239 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-31
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram normal, Drooling, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scan came back negative for a stroke. After physical tests and observations the Dr. determined I had Bell''s Palsy.
CDC Split Type:

Write-up: On 5/31/21 I got a headache and noticed blurry vision. At approximately 11pm I noticed I was dribbling when I drank from a cup. At 2am on 6/1 I went to the Medical Office at my work and spoke to the Nurse. After seeing my face the Nurse determined I needed to go to the ER immediately. I went to the ER . After CT scan and physical test they determined I had Bell''s Palsy.


VAERS ID: 1394018 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Bronchitis, Chest X-ray, Fibrin D dimer, Heart rate, Hypertension, Hypoaesthesia, Inflammation, Influenza like illness, Insomnia, Magnetic resonance imaging, Meningitis, Muscle spasms, Pericarditis
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Hypertension (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (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: OMEGA 3 [FISH OIL]
Current Illness: Cholesterol (cholesterol levels are a little bit on the high side.)
Preexisting Conditions: Comments: Always had healthy lifestyle, never had heart problems or blood pressure before, was not taking any medication.
Allergies:
Diagnostic Lab Data: Test Date: 20210414; Test Name: Blood test; Result Unstructured Data: Unknown; Test Date: 20210414; Test Name: Chest X-ray; Result Unstructured Data: Mild bronchitis; Test Date: 20210415; Test Name: Blood pressure; Result Unstructured Data: 148/130; Comments: BP was 148/130 (his BP baseline is around 120/75); Test Date: 20210415; Test Name: Heart rate; Result Unstructured Data: 96 bpm; Comments: 96 bpm (baseline 52-55 bpm).; Test Date: 20210421; Test Name: MRI; Result Unstructured Data: Normal; Test Date: 20210421; Test Name: Fibrin D dimer; Result Unstructured Data: Unknown; Test Date: 20210422; Test Name: Blood pressure; Result Unstructured Data: 195/138; Test Date: 20210422; Test Name: Blood pressure; Result Unstructured Data: 130/85
CDC Split Type: USJNJFOC20210608039

Write-up: LOW LEVEL INFLAMMATION IN PERICARDIA; LOW LEVEL INFLAMMATION IN MENINGES; HIGH BLOOD PRESSURE; ACUTE INFLAMMATORY RESPONSE; MUSCLE CRAMPS (LEGS); COULD NOT SLEEP; MILD BRONCHITIS; HALF SIDE OF THE FACE COMPLETELY NUMB; END OF THUMB GOING NUMB; FLU-LIKE SYMPTOMS; This spontaneous report received from a patient concerned a 57 year old White and Caucasian male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included cholesterol, and the patient always had healthy lifestyle, never had heart problems or blood pressure before, was not taking any medication. The patient experienced intolerance to medication when treated with Nurofen (ibuprofen) for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, Expiry: Unknown) dose was not reported, 1 total, administered on 06-APR-2021 on left arm for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included fish oil for cholesterol. On 07-APR-2021, around at 01:00 AM, the patient started having headaches and flu-like symptoms that he could manage without medication. On 14-APR-2021, in morning, he had severe muscle cramps (calves and feet), end of thumb going numb and left side of the face completely numb (bottom half of the cheek and underneath the throat). Also had severe headaches (scale 8/10), which was very unusual for the patient. The patient called his PCP who referred him to a local clinic, they drew blood and did a chest X-ray based on the symptoms. Chest X-ray revealed mild bronchitis. Doctor suggested him to go home and stay hydrated. On 14-Apr-2021 (during the night) , patient woke up with muscle cramps in legs and feet, could not sleep because of the severity of the cramps (scale 7 to 8/10) and severe headaches (scale 8/10), could not stay laying down. On 15-Apr-2021, patient visited physician''s office. Physician prescribed him steroids (prednisolone) and told him he had an acute inflammatory response to the vaccine and now has low level inflammation in pericardia and meninges (verbatim "inflammation in the bag around the brain and bag around the heart"). Patient''s blood pressure (BP) was at 148/130 (his BP baseline was around 120/75) and heartrate was around 96 bpm (baseline 52-55 bpm). Doctor prescribed propranolol. Heart rate went down with propranolol, but Blood pressure was still high, so Doctor switched to losartan 25 mg. He was diagnosed with tachycardia (heart pounding out of chest). On 21-APR-2021, Doctor has scheduled a MRI to rule out blood clots which was normal and also Fibrin D dimer, result was unknown. On 22-APR-2021, patient went to the emergency room, because blood pressure (BP) was 195/138. After receiving treatment, blood pressure was 130/85 and patient went home. Couple of days later, BP was high again, doctor added amlodipine 5 mg to losartan 25 mg and referred the patient to a cardiologist who then increased the dosage to amlodipine 10 mg. Patient now takes losartan 25 mg and amlodipine 10 mg. On 27-May-2021, the patient visited cardiologist and Scheduled Computed tomography scan and electrocardiogram on Monday. Primary care physician had prescribed magnesium supplement for the cramps. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu-like symptoms, had not recovered from muscle cramps (legs), and the outcome of end of thumb going numb, half side of the face completely numb, mild bronchitis, acute inflammatory response, low level inflammation in pericardia, high blood pressure, could not sleep and low level inflammation in meninges was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210608039 -covid-19 vaccine ad26.cov2.s- low level inflammation in pericardia, low level inflammation in meninges, high blood pressure. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabelled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1394030 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-05-27
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Haemoptysis, Miliaria, Platelet count, Platelet count decreased, Sinusitis
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210530; Test Name: Platelet count; Result Unstructured Data: down to 6
CDC Split Type: USJNJFOC20210616684

Write-up: PLATELETS WERE REALLY LOW DOWN TO 6; COUGHING SPOTTY BLOOD/COUGHED UP A MOUTH FULL OF BLOOD; SINUS INFECTION; BUNCH OF RED LITTLE DOTS ALL OVER BODY/WORSE ON RIGHT LEG/LIKE HEAT RASH; This spontaneous report received from a patient concerned a 61-year-old white and not Hispanic or Latino male. 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: 1808982, and expiry: UNKNOWN) dose was not reported, 1 total, administered on 13-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 27-MAY-2021, the patient experienced bunch of red little dots all over body which was worse on right leg like a heat rash. On 29-MAY-2021, patient thought he had sinus infection and started coughing spotty blood and then coughed up a mouth full of blood on 30-MAY-2021, went to emergency room because he was still coughing out blood. Patient''s doctor found that patient''s platelets were really low down to 6. Patient''s doctor gave him bunch of steroid and platelets. Patient was hospitalized on 30-MAY-2021 and discharged on 01-Jun-2021 and was given a steroid 40 mg a day. The patient recovered from coughing spotty blood/coughed up a mouth full of blood on 01-JUN-2021, and sinus infection, recovered with sequelae from platelets were really low down to 6 on 01-JUN-2021, and was recovering from bunch of red little dots all over body/worse on right leg/like heat rash. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0 : 20210616684- JANSSEN COVID-19 VACCINE-Coughing spotty blood , platelet were really low below 6. 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: 1394274 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-12
Onset:2021-06-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Disorientation, Dizziness, Electrocardiogram, Injection site hypoaesthesia, Injection site paraesthesia, Loss of consciousness, Nausea, Unresponsive to stimuli
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: abnormal EKG results that were done by the first responder 911 paramedics.
CDC Split Type:

Write-up: 37-year-old foreign-speaking patient walked into the vaccination site accompanied by wife at about 11:45am. They requested the Janssen Covid-19 vaccines for the both of them. Patient signed all necessary consent forms and pre-vaccination checklist requirements, and entered the vaccination section at around 11:50am. The Janssen vaccine was administered at 11:57am. At 12pm patient started to experience light-headedness, dizziness, and change of LOC. At 12:01pm charge nurse called 911. Patient?s wife and observation nurse asked patient how he was feeling but patient was unresponsive and disoriented for about 30-60 seconds. Soon after patient was able to speak and started complaining of being nauseous and observation nurse handed patient a garbage bag to throw up. Charge nurse hooked up patient with pulse oximetry at 12:02pm with a reading of 98. Nurse assessed if patient is experiencing any symptoms of hives or redness, shortness of breath or any difficulty breathing or swallowing, and patient denied any symptoms. Administering RN hooked up patient with the blood pressure machine and BP reading was 167/156 with a pulse of 56. At 12:03pm BP reading was 139/75 with a pulse of 62 and pulse ox reading of 95. At 12:06pm BP reading was 153/115 with a pulse of 67 and pulse ox of 95. Patient also stated that his left arm started to get numb and tingly feeling. At 12:07pm first responder 911 came and took over. Patient was hooked up to EKG and found some arrhythmia and was advised to go to the hospital to further evaluate. Patient agreed and was taken to the nearest hospital at about 12:20pm. Action taken: Charge nurse called 911 for help and hooked up patient with pulse oximetry and assessed patient for any sign and symptoms of any allergic reactions to Janssen Covid-19 vaccine. Administering RN and observation nurse continuously monitored patient?s B/P, Pulse, Pulse oximetry, and LOC until first responder paramedics came.


VAERS ID: 1394376 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-12
Onset:2021-06-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), 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: folic acid 1mg nortriptyline 10mg cap vitamin d2 50000 cap humalog insulin creon 36000 unit cap omeprazole 40mg mirtazapine 15mg clonidine 0.1mg tab fluoxetine 20mg cap hydroxyzine 50mg tab pregabalin 50mg cap
Current Illness: insulin dependent diabetes chrohns disease insomnia depressive disorder hypomagnesemia vitamin d deficiency
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt waited 25 after getting vaccine in the pharmacy then went shopping in the grocery store. 30 minutes post vaccine she fell to the floor and started having seizures. ems was called and pt was taken to the emergency room. pt''s husband was called at 3pm by pharmacy staff and she was being discharged from the hospital er.


VAERS ID: 1394418 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-10
Onset:2021-05-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Colon cancer metastatic, Computerised tomogram abnormal, Deep vein thrombosis, Dyspnoea, Embolism, Metastases to liver, Pain in extremity, Palpitations, Pulmonary embolism, Ultrasound scan abnormal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Non-haematological malignant tumours (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: Lisinopril, hydrochlorothiazide, metoprolol, sertraline, trazo
Current Illness: none reported ER visit from today found new metastatic cancer
Preexisting Conditions: Htn
Allergies: Vicodin
Diagnostic Lab Data: She was seen in the ER today and diagnostic tests are noted as above, with ultrasound showing right calf DVT and CT chest showing multiple bilateral pulmonary emboli, as well as CT a
CDC Split Type:

Write-up: The patient reports right calf pain 5 days after vaccination, followed by palpitations and dyspnea for the past two week. She presented to the ER today, June 12 2021, and was found to have a right calf DVT as well as multiple bilateral pulmonary emboli. Her ER visit today also shows newly diagnosed metastatic lesions in the liver and a colonic mass. It is not clear if any of the thromboembolic disease is secondary to the Covid vaccine at all, or all related to the new metastatic disease. Decision was made to report this event due to her reported timing of symptoms and patient request to report as well. She is being transferred to Medical Center for hospitalization and treatment.


VAERS ID: 1394639 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-12
Onset:2021-06-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest pain, Chills, Dyspnoea, Headache, Immediate post-injection reaction
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Mild non-covid cough 3 weeks prior
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Blood work and chest xray, returned normal
CDC Split Type:

Write-up: Immediate Site pain, headache after approx. 2 hrs, chills, chest pain, shortness of breath after about 8 hours. Chest pain continuing into next day


VAERS ID: 1394686 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-16
Onset:2021-04-18
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchoalveolar lavage abnormal, Bronchoscopy abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Eosinophilic pneumonia chronic, Sputum abnormal
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol (ACCUNEB) 0.63 mg/3 mL nebulizer solution 1 ampule, Nebulization, Every 6 hours PRN albuterol 90 mcg/actuation inhaler TAKE 2 PUFFS BY MOUTH EVERY 6 HOURS AS NEEDED FOR WHEEZE cetirizine (ZYRTEC) 10 MG tablet 10 mg, Oral, Daily fl
Current Illness: asthma
Preexisting Conditions: asthma
Allergies: slfates
Diagnostic Lab Data: Bronch 6/12/21 with BAL 62% eosinophils
CDC Split Type:

Write-up: ~ 30 days after vaccine, Pt developed increasing dyspnea. Treated with PO prednisone taper x 8 days with some improvement, however symptoms worsened off prednisone and she presented to ED on 5/3/21. Found to have multifocal PNA with significant peripheral eosinophilia. Treated with PO Abx and steroids again. Repeat CT in 6/21 shows worsening multifocal PNA with peripheral eosinophilia again. Admitted to hospital, bronchoscopy performed with results c/w chronic eosinophilic PNA. Started on IV steroids - $g PO with significant improvement in parencyhmal lung disease.


VAERS ID: 1394704 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blister, Oral mucosal blistering, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 42 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Test results can be emailed to VAERS with dates.
CDC Split Type:

Write-up: Broke out in Blisters over his whole body including his mouth. His whole body swollen.


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