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

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



Case Details (Reverse Sorted by Onset Date)

This is page 53 out of 1,889

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VAERS ID: 1214610 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Feeling cold, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza - October, 2021
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Formaldehyde Sulfa
Diagnostic Lab Data: BP 140/76
CDC Split Type:

Write-up: Anxiety, cold, tachycardic. Placed in supine position by EMTs (remained on-site). All symptoms resolved.


VAERS ID: 1214626 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

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

Write-up: blood transport vessel in left thigh throbbing for a few hours upon waking in the morning, very sore legs. The rest of the symptoms are considered normal for the covid 19 vaccine and they included fever, headache, fatigue, bodily aches, occasional recurring chills and injection site soreness.


VAERS ID: 1214650 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: Dizzy. Patient placed in supine position. Patient symptoms resolved with fluids.


VAERS ID: 1214671 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Oropharyngeal pain
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: B/P 126/74
CDC Split Type:

Write-up: Light-headed, dizzy, sore throat.


VAERS ID: 1214697 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-15
Onset:2021-04-12
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atelectasis, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Dizziness, Pleural effusion, Pneumonia, Pulmonary embolism
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Tylenol #3 One tab Q6H prn, Atorvastatin 40 mg QD, (Continued)
Current Illness:
Preexisting Conditions: Heart Transplant 1998, Anemia, Arthritis, CHF, ESRD on Hemodialysis, hyperlipidemia, hypertension
Allergies: Phenobarbital, Quinine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Patient received J&J COVID Vaccine on 3/15/2021 per vaccine card. Patient had an ED Visit on 3/17/2021 for a chief complaint of lightheadedness and was diagnosed with Pneumonia with Chest X-ray showing small bilateral pleural effusions with underlying atelectasis or consolidation. On 4/12/2021, Patient presented to ED as instructed by outside physician for finding of blood clot on CT the morning of 4/12/2021 (Pulmonary emboli at the left upper lobe). The patient had CT scheduled during an office appointment on 4/5/2021. Patient admitted for treatment of pulmonary embolism.


VAERS ID: 1214703 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Central nervous system lesion, Headache, Magnetic resonance imaging head abnormal, Malaise, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Head MRI, lesion on brain Spinal MRI - TBD
CDC Split Type:

Write-up: Fever after 24 HRS, sick and in bed all day. From Tuesday to date - leg stiffness and some headaches. Admitted to Hospital for testing, found lesion on brain.


VAERS ID: 1214713 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-29
Onset:2021-04-12
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Arterial stent insertion, Cardiac arrest, Catheterisation cardiac, Culture urine negative, Endotracheal intubation, Fibrin D dimer increased, Mechanical ventilation, Neurological symptom, Platelet count normal, SARS-CoV-2 test negative, Troponin I increased, Ventricular fibrillation, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: obesity BMI 47.4 kg/m2, heavy smoker
Allergies: Penicillin
Diagnostic Lab Data: Troponin I 2.25 on 4/12/21 2215; & 9.2 on 4/13/21 0538; D-dimer 7.77 on 4/12/21 2215; plt 290 4/12/21 2215; WBC 18.7 4/12/21 urine culture-no growth, COVID-19 not detected 4/12/21
CDC Split Type:

Write-up: 50 yo female with no medical history known to our system presents with Inferior STEMI with ventricular fibrillation cardiac arrest. Unknown initial downtime without CPR. Arrived by rescue squad and taken emergently to Cardiac Catheterization Lab, required mid-LAD stenting. Therapeutic temperature management (TTM), now rewarmed. Currently intubated on mechanical ventilation, on norepinephrine, poor neurological responses, consider neurology consult for brain evaluation/prognostic recommendations. There is a progress note written by ED RN on 4/12/21 that states family reports she had "her 2nd COVID shot 1 week ago," but per Wisconsin Immunization Registry, only 1 COVID vaccine is recorded.


VAERS ID: 1214739 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Magnetic resonance imaging abnormal, Thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: diabetes
Preexisting Conditions: diabetes
Allergies: Erethamiasen, adhesive tape
Diagnostic Lab Data: was in the hospital and MRI was done that showed a blood clot that caused the stroke
CDC Split Type:

Write-up: I had the the vaccine on Friday then Monday i had a stroke from a blood clot


VAERS ID: 1214745 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / IM

Administered by: School       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Dyspnoea, Electrocardiogram normal, Fibrin D dimer normal, Full blood count normal, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprintec, Multiple Vitamin, Baby ASA 4/14/21
Current Illness: No
Preexisting Conditions: None
Allergies: NDKA
Diagnostic Lab Data: CBC, CMP, EKG, D-dimer, and Chest Xray all within normal limits, normal, or negative. Vital signs stable. O2 sat 99%
CDC Split Type:

Write-up: 3 days post vaccine short of breath on exertion and chest tightness


VAERS ID: 1214751 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 043A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Labyrinthitis, Vertigo
SMQs:, Vestibular disorders (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:
Current Illness: none
Preexisting Conditions: breast cancer and dementia
Allergies: sulfa causes rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: vertigo due to peripheral labyrinthitis


VAERS ID: 1214878 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: Patient states he was taken by ambulance to emergency department where he was treated, observed and later released that same afternoon.
CDC Split Type:

Write-up: Patient received Janssen COVID19 vaccine at 9:30am. Upon receiving vaccine he sat down on chair to wait for 15 minutes post-vaccination. Just minutes after sitting down patient lost consciousness, fell from chair, and hit his head on a nearby countertop in room. He fell on his side on floor, EMS were called, and ice pack was placed on his head while awaiting EMS arrival.


VAERS ID: 1214917 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain, Pain in extremity, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: morphine 15mg, oxycodone 10mg, gabapentin 300mg, glipizide 5mg, eliquis 5mg blood thinner, asperin 83mg.
Current Illness: arterial vascular disease, diabetis
Preexisting Conditions: waiting to get an arterial artery bypass due to blockage
Allergies: Penicilin
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: severe head ache, soar throat, swelling of jaw, pain in legs and feet


VAERS ID: 1214924 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral artery occlusion, Cerebrovascular accident, Computerised tomogram head abnormal, Facial paresis, Hemiparesis, Magnetic resonance imaging head abnormal, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Janssen COVID-19 Vaccine EUA. One day after vaccine, patient reports onset right sided weakness (face, upper and lower extremities). Found to have stroke on brain imaging: L inferior M2 branch occlusion.


VAERS ID: 1214960 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-31
Onset:2021-04-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood creatinine increased, Dehydration, Electrocardiogram normal, Fatigue, Full blood count abnormal, Influenza virus test negative, Metabolic function test abnormal, Pain, SARS-CoV-2 test negative, Troponin, Troponin normal, Urine leukocyte esterase positive, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic leukopenia (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine, celexa, cozaar, lomotil, premarin, meclizinee, omega-3, melatonin, vit d3, multivitamin, calcium citrate, biotin, black cohosh, naproxen, ibuprofen, tylenol
Current Illness: patient did have similar symptoms develop after first pfizer shot
Preexisting Conditions: multiple sclerosis
Allergies: none
Diagnostic Lab Data: cbc significant for elevated WBC, CMP significant for elevated creatinine, flu test was negative, covid test negative, ekg normal, troponin negative, urine with small leukocyte esterase, clear otherwise, no nitrites
CDC Split Type:

Write-up: patient has become extremely fatigued and is experiencing bodyaches for several days. she had the same thing happen to her after the first shot, but this only lasted for 2 days and resolved. this time her symptoms are lasting for 4 days and because they are not resolving, she is in the ED. she is also found to be clinically dehydrated


VAERS ID: 1214968 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Feeling hot, Headache, Hot flush, Nausea, Nervousness, Pyrexia, Stress, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 30 minutes after the injection I developed a significant headache and nausea. Approximately one hour later if I was in the sun I became overheated, flush and an overall feeling of nervousness, I adapted to these symptoms knowing they would considered normal but I no longer feel these should be considered normal. Around 7pm on Monday I started running a fever that started at 101.1. Between Monday night and Thursday morning it bounced around but stayed between 101.1 and 103.2. It did not go away completely until Thursday morning. At least I hope it is gone for good. On Wednesday around 10am I developed abdominal pain that by 4pm had me sitting by my car unable to continue for about 10 minutes. It was extremely stressful and still to the time of this report is still has not completely gone away. The most concerning for me is the back pain with it. At the time of this report I still have a headache, nausea, abdominal pain with back pain and vertigo. I have contacted my doctor''s office and they have made notes but suggested I report everything here. They have started me on baby aspirin and electrolytes as I am also experiencing interment diarrhea.


VAERS ID: 1214980 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Altered visual depth perception, Arthralgia, Aura, Blood test normal, Cardiac imaging procedure abnormal, Chest X-ray normal, Chest pain, Computerised tomogram abnormal, Dizziness, Dysgeusia, Electrocardiogram normal, Feeling abnormal, Heart rate irregular, Myocardial necrosis marker normal, Nausea, Pain in extremity, Paraesthesia, Parosmia, Pericarditis, Retching, Scan with contrast abnormal, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Tetanus hives, vomiting age 32
Other Medications: Synthroid, Xanax, Aspirin, Atenolol, Amlodipine, Omeprazole,
Current Illness: ear infection diagnosed and treated almost 4 weeks before Simvastatin, Diazepam, Cephalexin, Tetracycline. Latex. Contrast Dye (esp. iodine ones), vaccines. Cleaners, insect sprays Paint fumes, Shellfish.
Preexisting Conditions: paralyzed vocal cord, hypothyroidism, hypertension
Allergies: Penicillins, Erythromycin, Oxycodone Acetaminophen, Niacin, Gabapentine, Simvastatin, Fluticasone Propionate
Diagnostic Lab Data: 4/12-13/21 EKGs, chest X-rays and blood tests normal, cardiac enzyme tests showed no heart attack. 4/13/21 Heart CT showed inflammation of the pericardium. The Cardiologist said it m was caused by the Covid 19 immunization. I was placed on colchicine for 2 weeks. I was given follow-up appointments with my primary care physician and the cardiologist. These are results my husband and I were told during my hospital stay but I do not yet have the documentation in hand.
CDC Split Type:

Write-up: Strange odor a few minutes after injection, followed by bitter taste, then nausea and spaciness. Dizzyness, with vision looking 2D and flat by 15 minutes. Told Pharmacist, of spaciness who said stay as long as I wanted. Left at 30 minute point, still spacy and nauseous. Spaciness ended by an hour with nausea off and on. Chest pain - began around 7pm, continued to expand in area of chest, sharp stabbing pain later, pain from just above left elbow to hand and tingling of fingers, pain lower left leg and tingling of left foot. Irregular heart rate at different times. Checked into emergency room at 11:00. IV inserted, placed on continual heart and oxygen monitors, EKGs, chest X-rays (2), blood tests (3). Admitted to hospital sometime during the night. Given IV medications to counteract IV contrast allergy. These medications caused full body shakes, eyesight auras and extreme nausea with gagging. Heart CT taken with IV contrast. Discharged around 3:00 PM.


VAERS ID: 1214988 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Fatigue, Headache, Influenza like illness, Injection site pain, Myalgia, Neck pain, Night sweats, Pain, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I opted for the J&J variant and received it on Monday at 1:00 PM, mere hours before they pulled distribution of it on the national level. I started feeling flu like fatigue, body aches, and a headache 8 hours post injection. I ran a 101+ fever Monday night and got less than 4 hours sleep due to fever and fairly intense muscle aches. On Tuesday morning the headache, fever and muscle aches persisted till the late evening accompanied by general fatigue. By 9:00 on Tuesday night I was feeling significant improvement and slept well Tuesday night with minor night sweats on and off. Wednesday morning I felt 80% back to normal. No fever, minor headache only evident when standing up quickly or sudden head movement, and continued muscles aches body wide specifically in the neck and chest as well as injection site muscle soreness. These symptoms continue to persist into Thursday at the same or perhaps slightly elevated levels. Friday 4/15 symptoms persist with generalized soreness, fatigue, headache, injection site soreness. Not his typical self.


VAERS ID: 1215014 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Asthenia, Dizziness, Dyspepsia, Gait disturbance, Headache, Laboratory test, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10MG once daily Carvedilol 12.5 MG twice daily Atorvastatin 40 MG once at night Pantoprazole 40 MG once daily
Current Illness: None
Preexisting Conditions: Tachycardia Asthma Scoliosis High Blood Pressure GURD
Allergies: Penicillin Shell Fish Contrast Dye Benedryl Bees
Diagnostic Lab Data: Blood work ordered by Primary April 14, 2021 and done on April 15, 2021. Awaiting results
CDC Split Type:

Write-up: Monday started having swelling behind my neck between my two shoulders and then a headache began. Went to Healthcare expressed by the doctor did not think it was blood clot, but probably related to the vaccine. Gave me a steroid and muscle relaxer sent me home to call provider next day. Had Televisit with primary?s Wednesday April 14, 2021, by then news had broke about the new type of blood clot CVST and the low platelet count, I explained still had headache and swelling, sour stomach over night(have had this before) and felt weak for a brief few minutes on right side but quickly went away, also was walking for a brief few minutes like I was drunk, again went away after a few minutes. Discussed with primary my anxiety could be contributing to some of the extra feelings I was having, agreed to do bloodwork to check platelet levels. She did not think it was blood clots discussed with me about what I needed to look for and to go to ER immediately if I experienced any of them. Blood work did today, Thursday April 15, 2021. still headache and some swelling in back of neck between shoulders, dizzy off and on. All pain moderate to mild. Awaiting blood work for next step.


VAERS ID: 1215029 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac failure, Catheterisation cardiac abnormal, Coronary artery dissection, Echocardiogram normal, Myocardial infarction, Troponin increased
SMQs:, Cardiac failure (narrow), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: High sensitivity troponin up to 7600 , on 4/14/21 Normal epicardial arteries by catheterization on 4/14/2021 except for very distal spontaneous dissection in small OM branch. Normal echocardiogram on 4/15/2021
CDC Split Type:

Write-up: Subendocardial Myocardial Infarction three days after the second dose. Heart function appears preserved.


VAERS ID: 1215086 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol, Tekturna, carvedilol, chlorthalidone, zetia, farziga, januvia, lovasa, vitamin D, vitamin C
Current Illness: None
Preexisting Conditions: High blood pressure, high cholesterol
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Instant intense pain and burning. 3 days later continued soreness at injection site.


VAERS ID: 1215094 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Condition aggravated, Electrocardiogram, Fall, Head injury, Hypotension, Loss of consciousness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), 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 (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Patient states she received an EKG while at the ED, then released later that afternoon post-observation.
CDC Split Type:

Write-up: Patient received Janssen COVID19 vaccine at 10:15am. Upon receiving vaccine she sat down on chair to wait for 15 minutes post-vaccination. Just minutes after sitting down patient lost consciousness, fell from chair, hit her head on the floor, seize for a short moment, only to momentarily regain consciousness, and faint for a second time. EMS were called and patient was transported to Emergency Department for testing and observation. Patient believes she fainted the first time due to not having eaten much by that point in the day and due to anxiety about receiving the vaccine, and she was told she fainted a second time due to hypotension. She states she has a history of previously fainting during other medical procedures, though no similar previous reactions she can recall after vaccines.


VAERS ID: 1215099 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-03
Onset:2021-04-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), 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:
CDC Split Type:

Write-up: left knee swelling


VAERS ID: 1215150 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A212A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Decreased appetite, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, chills, body aches, loss of appetite, stomachache.


VAERS ID: 1215395 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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

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

Write-up: I broke out into hives and couldn?t stop itching my torso from 600pm to midnight. I took 2 Benadryl at 700pm and still had horrible itching. At 1000pm I took 1 more Benadryl and the itching subsided at midnight. This occurred 6 days after my vaccination.


VAERS ID: 1215397 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Anticoagulant therapy, Exposure during pregnancy, Pelvic venous thrombosis, Ultrasound antenatal screen abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Ultrasound 4/12/2021
CDC Split Type:

Write-up: 4/1/2021 patient received JNJ Vaccine 4/12/2021 Miscarriage was confirmed on Ultrasound done by and also Right Pelvic vein thrombosis seen. 4/13/2021 Patient placed on Anticoagulation.


VAERS ID: 1215439 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL,/LISINOPRIL/ATORVASTATIN/BUPROPION,
Current Illness: N/A
Preexisting Conditions: HIGH CHOLESTEROL/ELEVATED BP
Allergies: SULFA
Diagnostic Lab Data:
CDC Split Type:

Write-up: a bruise in the area of the left upper nose and left eyelid between the nose and eye and including half of the eyelid


VAERS ID: 1215452 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 014A21P / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Contusion, Fatigue, Headache, Impaired work ability, Malaise, Nausea, Pain in extremity, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Was stressed and run down in weeks prior to shot (taking care of mother dying of cancer who passed 04//01/21) so was not able to determine if experiencing side effects of just continued fatigue. Sore arm, bruised. Monday evening 04/12/21 felt sick, nauseous. Unusual for me. Continuing to feel sick each day since then and called in sick to work today. When I move around I feel worse. My chest feels like I am on the verge of getting really sick. I can breathe but just do not feel good. Feel worse when having a conversation with people. Feel better resting. I have no fever. My blood pressure and heart rate are normal. This is the sickest I have felt since before the pandemic. I called a nurses hotline yesterday and was told to call 911 is I had chest discomfort. I do not feel sick enough to call 911 and could drive myself if I need to go to the hospital. Best way to describe my symptoms is feel like I am on the verge of getting a bad chest cold. Had a headache last night and did not take anything. Woke up in the middle of the night with a very painful headache and took 2 Tylenol which made the headache subside. I have been feeling worse each day since Monday. Today is Thursday. Am wondering if I have COVID-19 and have called a clinic to schedule a COVID test that will be paid for by my work. Am waiting for a return call. All I know is that I feel sick and was not feeling this way before having the vaccine.


VAERS ID: 1215524 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Dizziness, Feeling cold, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Effexor, Vitamin B, D3, Omega-3
Current Illness:
Preexisting Conditions: Fibromyalgia
Allergies: Codeine and Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever of 102. Head ache. Total body aches. Dizzy off balance extreme cold and sore of entire body very weak.


VAERS ID: 1215836 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Crying, Dizziness, Eye pain, Feeling abnormal, Headache, Nausea, Pain, Pain in extremity, Paranasal sinus discomfort, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: I called my pcp 2 days in a row and was met with long hold times the first day. I hung up and called the next day, they scheduled me a phone consult which has yet to occur. I''m waiting, hoping this goes away soon on its own.
CDC Split Type:

Write-up: Felt fine at time of shot, a little achy afterwards but nothing concerning. My legs ached some a few days after but got better. About 3 days ago I started getting a major headache on the right side that also arrived with blurry vision, mental fog and mild dizziness. Nausea yesterday and today except the headache was much worse. I cried from the pain and this is when I became more concerned. My eyes, mainly the right side and a pressure in my sinuses were very difficult to bare with, subsided some with multiple doses of ibuprofen and Advil sinus but not by much. The headache is unbearable, painful to stand out bend over or move.


VAERS ID: 1215917 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Muscle spasms, Musculoskeletal discomfort, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Experienced some blood in the rectum area.
Preexisting Conditions: Allergies.
Allergies: Aspirine, Erythromycin, acetaminophen.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Monday around 11:30pm started experiencing headaches, fever, muscle cramps, and body aches. Next morning the headache and body aches persisted through the day. Only taken 1 benadryl, 4 loratadine. Wednesday night taking a shower started feeling some discomfort on the left side of my neck. Today 4/15/2021 still bothers. Feel like a swollen muscle or ganglion.


VAERS ID: 1215955 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Facial pain, Fluid retention, Migraine, Peripheral swelling, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aleve
Current Illness:
Preexisting Conditions: Obesity,anxiety,chronic pain due to car accident
Allergies: Lyrica
Diagnostic Lab Data: None as of yet but I will b visiting the emergency room today.
CDC Split Type:

Write-up: Severe Dizziness day of injection and mild dizziness for next 3 days severe migraine like headache with vomiting starting 4 days after injection and continuing to present. Day 8 post injection the headache has started to move into front of my head and face. As well as retaining fluid and swelling in my lower legs.


VAERS ID: 1215959 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Heart rate decreased, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: dizziness, excessive sweating, low heart rate


VAERS ID: 1215961 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

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

Write-up: Pt c/o slight tightening of the throat that occurred @1535. No itchiness. Pt advised to take deep breathes and drink water. Pt speaking in clear full sentences. No apparent distress. Pt notified and shown vital signs stable. Closing of the throat worsened. Pt requested epinephrine due to "closing of the throat." Epinephrine given at 1554 pt stated throat opening and breathing effortless. Vital signs taken please review. 1613 pt states closing of the throat has not gone away but feels better. Pt speaking in full clear sentences alert Nurse supervisor, Chief Doctor, were notified. Dr. assessed pt and 911 was called at 1620. Pt transferred @ 1632


VAERS ID: 1215972 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / UN

Administered by: School       Purchased by: ?
Symptoms: Dysphagia, Feeding disorder, Insomnia, Lymphadenopathy, Myalgia, Night sweats, Pain, Pyrexia, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (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 (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristiq 75mg daily, iron supplement and vitamin C supplement
Current Illness: None
Preexisting Conditions: None
Allergies: Anaphylaxis/severe allergy to cashews and pistachios
Diagnostic Lab Data:
CDC Split Type:

Write-up: Insomnia first night, fever lasting a few hours beginning 12 hours after the shot. Body aches and exhausted muscles the next day. Night sweats lasting four days (ongoing), swollen lymph nodes in neck. Left lymph node is the size of an egg, right node the size of a grape. Nodes are getting so swollen it is affecting ability to eat, drink, swallow and talk. Feels as if it is restricting throat. Taken single acetaminophen dose night of the vaccination (4/11/21), and one 4/15/21.


VAERS ID: 1215994 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza like illness, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Amlodipine, prednisone, omeprazole, Simvastatin
Current Illness: None
Preexisting Conditions: High blood pressure, high cholesterol,
Allergies: Sulfur, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was having flu like symptoms, then tested leg swelled up below right knee , now still swollen and bruising down leg


VAERS ID: 1216012 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Headache
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ongoing abdominal pain and headache since the vaccine.


VAERS ID: 1216059 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Full blood count, Headache, Metabolic function test, Urine analysis
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Losartan Potassium, Carvedelol, glipizide, Trulicity, Treseba
Current Illness:
Preexisting Conditions: Diabetes, hypertension
Allergies: Lisinopril, can squash
Diagnostic Lab Data: 4/13/21 Urgent care did not do labs..and Emergency department on 04/14/21 CBC and Differential, Comprehensive Metabolic Panal, Urinalysis with Microscopic, C/T of head without contrast,
CDC Split Type:

Write-up: Headache, Bell''s Palsy


VAERS ID: 1216149 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

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

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

Write-up: Patient age 16 received Janssen vaccine (approved for ages 18+) at vaccine clinic on 4/12/21. Error was discovered on 4/15 during processing - pharmacist was unaware of age at time of administration.


VAERS ID: 1216162 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Myalgia, Nausea, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Azopt, B Complex, Bromocriptine, Bupropion, Clopidogrel, Glimepiride, Invokana, Januvia, Latanoprost, Rosuvastatin, Zolpidem Tartrate
Current Illness:
Preexisting Conditions: Glaucoma, Prolactinoma, Depression, Clogged Arteries, Diabetes type 2,High Cholesterol, Insomnia
Allergies:
Diagnostic Lab Data: None
CDC Split Type: 6105053

Write-up: Both arms with unbearable muscle pain, nausea, diarrhea


VAERS ID: 1216176 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

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

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

Write-up: Patient age 17 received Janssen vaccine (approved for ages 18+) at vaccine clinic on 4/12/21. Error was discovered on 4/15 during processing - pharmacist was unaware of age at time of administration.


VAERS ID: 1216243 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Dyspnoea, Epistaxis, Headache, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: ROS: (10+) CONSTITUTIONAL: subjective fever, subjective chills, no night sweats EYES: No blurry vision, no loss of vision, no black spots, no curtain of lights. EAR, NOSE, THROAT
CDC Split Type:

Write-up: Pt received J&J vaccine at 0900 on Monday. Pt had ha and bodyaches on Monday night. Tuesday went to clinic for HA and bodyaches and was given tylenol. Pt woke up on Wednesday with a nose bleed and stomach ache. CHIEF COMPLAINT & HPI: 23 yo M here with epigastric pain, nausea, shortness of breath, fever, chills, since receiving the covid vaccine several days ago.


VAERS ID: 1216256 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fibrin D dimer increased, Full blood count, Headache, Pain in extremity, Peripheral swelling, Red blood cell sedimentation rate, Ultrasound Doppler normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage laboratory terms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Kyleena 19.5 MG Intrauterine , Notes: placed 04/06/2021 Cholecalciferol 25 MCG (1000 UT) Capsule 2 capsule Orally Once a day Levothyroxine Sodium 150 MCG Tablet 1 tablet Orally Once a day MagOx 400 400 (241.3 Mg) MG Tablet 1 tablet with foo
Current Illness: none
Preexisting Conditions: hypothyroid, hyperlipidemia, obesity, seasonal allergies
Allergies: Latex - hives
Diagnostic Lab Data: Ultrasound, CBC, sed rate, d-dimer; Stat US completed and read returned: There is no evidence of luminal thrombus. There is normal augmentation to flow and preserved respiratory variation. No superficial venous thrombus identified. Impression: No left lower extremity deep vein thrombosis. Stat labs ordered. CBC and sed rate both within normal limits. D-dimer slightly elevated at 0.58 (RR 0.00-0.50)
CDC Split Type:

Write-up: : Thigh: R leg 21'''' L leg 23'''', Calf: equal bilaterally. L leg pain and swelling. Started after receiving the Janssen COVID vaccine on Thursday. The pain started as bilateral and then resolved. It returned on Monday in her left leg, starting in her anterior thigh and radiating down her leg. States that her leg began swelling today and had increased pain. Denies redness and heat to her leg. Pain is worse with ambulation. She states that it does not feel like the sciatica that she experienced in the past. Patellar reflexes equal bilaterally. Denies chest pain, shortness of breath. Admits to headache that has been present for a number of days and is resolving. Denis light and noise sensitivity. Neuro exam WNL.


VAERS ID: 1216260 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-08
Onset:2021-04-12
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Erythema, Fatigue, Flushing, Headache, Immediate post-injection reaction, Muscle spasms, Nausea, Pain in extremity, Peripheral swelling, Skin warm, Sleep disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Right after the dose I got an immediate headache, dizzy and light headed. About an hour later I became nauseous and my face became very flush red and hot. I went to bed and woke up feeling like I got hit by a truck and was very tired with a sore arm. By the next day I was better. The following week I began with a red hot circle on my arm where the shot was given, it had a ring around it. That lasted for about a week. I then started to get stinging sensations in that part of my arm like I was being stung by a bee. These lasted for about 2 days. I then started getting muscle rolls/spasms in the same spot on that arm. They lasted about 3 days. I then started having pain in that arm like I had just gotten the shot and as I was rubbing it, I noticed a large indent in my arm. I went to the doctor, and they said they had no idea why it happened but if I get more symptoms to come back. The doc appt was on 4/12/21. It has been over a month of these side effects. Doctor not sure if it will be a permanent disfigure.


VAERS ID: 1216261 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Cold Chills, Fever (102.5), nausea, headache, muscle aches and pain at injection site lasting for 24 hours after shot. Still feeling fatigue after 2 days. Self-treatment at home with Tylenol.


VAERS ID: 1216418 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-03
Onset:2021-04-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Catheterisation cardiac abnormal, Chest discomfort, Electrocardiogram, Fatigue, Headache, Pericarditis, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Loss of consciousness, 66,flu vaccine
Other Medications: Aspirin, atorvastatin, carvedilol,telamisartan, finisteride, humalog insulin, hctz, Allegra, fish oil, b complex, vit D, folic acid
Current Illness: None
Preexisting Conditions: Diabetes, HTN
Allergies: PCN
Diagnostic Lab Data: Rapid test x 2 negative abnormal ekg, heart cath diagnosis pericarditis. All on 04/15/2021
CDC Split Type:

Write-up: Severe headache with fatigue started 04/12/2021. 04/14/2021 tightening in chest. went to local urgent care clinic for rapid test and treatment. EKG done also. Showed abnormal.,sent to local ER. Diagnosed with possible STEMI. Ems ride to north cath lab. Heart cath diagnosis of Pericarditis.


VAERS ID: 1216439 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-04
Onset:2021-04-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Cerebral venous sinus thrombosis, Headache, Hypertensive urgency, Nausea, Venogram, Vomiting
SMQs:, Acute pancreatitis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, Atorvastatin, Carvedilol, Hyrdralazine, Ipratropium nasal, Olmesartan
Current Illness: None known
Preexisting Conditions: Hypertension; Chronic renal insufficiency, Stage III
Allergies: Nifedipine
Diagnostic Lab Data: MRV- 4/15/2021 CTA with Venogram- 4/15/2021
CDC Split Type:

Write-up: Severe headache 2 days in duration with associated nausea and vomiting, admitted with hypertensive urgency, Cerebral Venous Sinus Thrombosis diagnosed via MRV and CTA


VAERS ID: 1216481 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A12A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site pruritus, 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PANTOPRAZOLE SOD 40MG TAB - 1 qd HYDROCOD/ACETAM 5-325MG TAB - 1 q 6 h prn Methotrexate 2.5 mg - 9 tabs per week Folic Acid 1 mg - 1 qd
Current Illness: Patient had COVID in February 2021, Viral enteritis possible influenza in March 2021 - not diagnosed by PCR/lab.
Preexisting Conditions: Hx of Ulcers, Rheumatoid Arthritis, Chronic Pain.
Allergies: No Known Drug Allergies
Diagnostic Lab Data: None to date
CDC Split Type:

Write-up: Warm, itchy red patch approximately 2 inches below vaccine site. Swollen, itchy, erythametous, and warm to touch, painful. Tired.


VAERS ID: 1216489 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea, Pallor, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses. After the fact we discussed pt hadn''t slept much the night before and hadn''t eaten much the day of, which we discussed could definitely have contributed.
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: I gave the vaccine around 6:20pm after counseling on possible adverse reactions and going over the patient''s questions. I then asked them to wait 15min. Within 5-10mins the patient got up and came back to our counter saying he thinks he''s having a reaction. I pulled him back into our vaccination area and had him sit down and explain what he was feeling to me. He looked pale and told me he felt dizzy, sweaty, shaky, & nauseous. He wanted me to grab him a bag incase he puked. I grabbed a bag as well as water and Benadryl. I asked if he was having any issues breathing or if it felt like his tongue was swollen at all. He said no issues breathing and tongue felt fine. He started to feel better within about 10-15 minutes after onset. He did not puke and his color returned. I had him wait an additional 10-15 minutes after that to make sure we were recovered. I asked him if there was anything else going on and he mentioned that he hadn''t slept well the night before and that he had barely eaten today. He also mentioned he can get anxiety. I told him all of those factors could certainly contribute to what he just experienced but that I would be reporting this on to be safe.


VAERS ID: 1216492 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, saphris 10 mg po bid, cogentin 0.5 mg po bid, clonazepam 2 mg po tid, gabapentin 600 mg po tid, zyprexa 5 mg po nightly, propranolol 20 mg po tid prn anxiety, topamax 100 mg daily and trazodone 50 mg nightly
Current Illness: none
Preexisting Conditions: schizophrenia and anxiety
Allergies: none
Diagnostic Lab Data: doppler ultrasound LLE 4/13/2021
CDC Split Type:

Write-up: developed pain in the left popliteal fossa 4/12/2021, ED visit 4/13/2021 with doppler ultrasound positive for DVT, pt started on apixaban.


VAERS ID: 1216575 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dreamy state, Fatigue, Mental impairment, Muscle twitching, Muscular weakness, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100 milligrams. Adderall 20 milligrams instant release.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme exhaustion, unable to think clearly, in a dream like state, body ache, muscle weakness and twitching, fever, nausea, vomiting


VAERS ID: 1216597 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Decreased appetite, Diarrhoea, Dyspnoea, Fatigue, Headache, Injection site erythema, Injection site pain, Injection site warmth, Nausea, Rash
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram, NP Thyroid, Nexium
Current Illness: None
Preexisting Conditions: Hashimotos Thyroiditis, depression, allergies, eczema, GERD
Allergies: Sulfa based drugs, oily fish, nuts, soy
Diagnostic Lab Data: No medical tests
CDC Split Type:

Write-up: About an hour after receiving the vaccine I started having difficulty breathing and it went into an asthma attack. I used my rescue inhaler which I keep on hand due to allergies. I used it 3 times that afternoon and evening. I felt nauseated but did not vomit. I had watery diarrhea twice. Nausea continued for 24 hours with loss of appetite. That has now abated. The injection site did not hurt until the next day when it started with tenderness then quickly turned red and painful and hot to the touch. Wednesday and Thursday the arm started getting a rash and it has spread up to the neck and face. Headache started the night of the injection and became intense (near migraine level) and stayed painful for 24+ hours. Fatigue began the night of the injection and has gradually gotten better over Wednesday and Thursday. Treated with Tylenol, rescue inhaler, Benadryl and hydrocortisone creams, rest, drinking lots of water, and notified my family doctor. Although I still have a rash and the injection site is hot and sore, I am considering myself recovered from the side effects.


VAERS ID: 1216623 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: severe headache, fever and body aches for approximately 16 hours


VAERS ID: 1216639 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Computerised tomogram head, Computerised tomogram normal, Diarrhoea, Fibrin D dimer normal, Headache, Mucosal hypertrophy, Oropharyngeal pain, Pain, Palpitations, Scan with contrast, Tachycardia, Troponin normal, Urine analysis, Urine leukocyte esterase, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: chronic sinus infections
Preexisting Conditions:
Allergies: Benadryl, Decadron
Diagnostic Lab Data: ROS: General: No fatigue, fevers, + chills, + malaise Eyes: No eye pain, eye discharge, visual changes Ears: No ear pain, hearing changes Nose/throat: No nasal congestion, sore thro Additional information for Item 19: ROS: General: No fatigue, fevers, + chills, + malaise Eyes: No eye pain, eye discharge, visual changes Ears: No ear pain, hearing changes Nose/throat: No nasal congestion, sore throat CV: No chest pain, + palpitations, no syncope or edema Pulm: No SOB, wheezes, cough, hemoptysis GI: No anorexia, abd pain, nausea, vomiting, diarrhea GU: No dysuria, hematuria, urgency, frequency MSK: No joint pain, edema, warmth, redness, deformity Neuro: + HA, no seizures, weakness, numbness/tingling, vertigo, lightheadedness, AMS Skin: No rash, lesions, itching Heme: No easy bruising/bleeding, petechiae All systems reviewed and negative except as stated above. Physical Exam: Vital signs reviewed, no acute intervention necessary General: NAD, AOX3, cooperative Head: Normocephalic, atraumatic Eyes: PERRL, EOMI, no conjunctival injection, no scleral icterus Ears: No edema/erythema of otic canal, no TM edema/erythema/dullness/bulging Nose: No nasal discharge Throat: No pharyngeal edema, erythema, tonsillar exudates, uvular deviation, asymmetric swelling, trismus, drooling, or voice changes Neck: No meningismus; normal ROM Lymph: No cervical lymphadenopathy Respiratory: Unlabored breathing, normal respiratory effort, LCTAB CV: Normal peripheral circulation, slight tachycardia, RRR, no m/r/g Abd: Soft, NTND Skin: No rashes, petechiae, or purpura Neuro: Grossly intact, moves all extremities equally, gait normal MSK: No TTP, deformity, ecchymosis, or focal edema Psych: Normal mood, normal affect, appropriate responses EKG #1 : sinus tach 109, normal intervals, no ectopy, ST depression II, III, avF and V3-V4 EKG#2 : NSR 94, normal intervals, no ectopy, ST depression isolated in aVF Labs: remarkable only for WBC 12.7, UA with leuk esterase. Neg d-dimer, neg delta troponins Imaging: Head CT: EXAM: CT Head with and without Intravenous Contrast. CLINICAL HISTORY: W/ contrast, HA, r/o bleed, r/o clot TECHNIQUE: Axial computed tomography images of the head/brain with and without intravenous contrast. CONTRAST: With and without; APPLIED 80mL Visipaque 320 @ 4mL/s COMPARISON: None provided. FINDINGS: BRAIN No evidence of acute hemorrhage. No mass lesion. No abnormal enhancement. No CT evidence for acute territorial infarct. No midline shift or extra-axial collections. VENTRICLES: No hydrocephalus. ORBITS: The orbits are unremarkable. SINUSES AND MASTOIDS: The mastoid air cells are clear. There is moderate to severe mucosal thickening within the left maxillary sinus, ethmoid air cells, sphenoid sinus and left side of the frontal sinus. BONES:
CDC Split Type:

Write-up: Body aches, headache, chills and sore throat since pt got J&J vaccine on 11Apr2021. Took some tylenol this morning without relief. Patient is a 35 year old female who presents to ED with body aches, headache, chills, palpitations for 3 days. She received the J&J vaccine on 11 April. She denies any fevers, no cough, no chest pain. She denies any vomiting, has been eating and drinking well. Some loose stools. No other sick contacts. She has a history of chronic sinusitis.


VAERS ID: 1216671 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Dysphagia, Headache, Lymphadenopathy, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Zyrtec
Current Illness:
Preexisting Conditions: Asthma, Eosinophilic esophagitis.
Allergies: Food Allergies; Eggs, wheat, mustard, peanut, pumpkin seed, bell pepper, broccoli, radish, banana, date, pineapple, clam, persley, ginger, vanilla, black tea, honey, sorghum, millet, hemp, tapioca, potato.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/10/21, Swollen/ sore lymph nodes left arm pit. 4/12/21, Trouble swallowing food. Flare up of EoE 4/13/21, Dizziness, low grade headache, tingling of skin on face and hands. Elevated response to seasonal and food allergies . Ongoing 4/15/21, Swollen/ sore lymph nodes right arm pit.


VAERS ID: 1216692 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / IM

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

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

Write-up: Tinnitus. My ears are constantly ringing. It?s causing a little bit of headache (headache goes on and off). It started about 2-3 days agreed getting the first dose of the vaccine, and it?s been here since then until this moment.


VAERS ID: 1216714 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Conserta was taken a week before vaccination.
Current Illness: na
Preexisting Conditions: asthma, no recent flare ups
Allergies: Bees
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: NO adverse event occurred. We are reporting due to the fact that the patient was 16 years of age and the vaccine has an 18 years of age requirement. Patient has had no symptoms. Is patient considered fully vaccinated at 2 weeks like adults 18 years of age or older? Patients parent would like to know as well.


VAERS ID: 1216769 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZEREW0153 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZEREP7534 / 1 LA / SYR

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

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

Write-up: Tinnitus


VAERS ID: 1216775 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 - / SYR

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

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

Write-up: Pulsitle tinnitus


VAERS ID: 1217352 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Unknown
Preexisting Conditions: Endometriosis
Allergies: None
Diagnostic Lab Data: I don''t have a doctor and have not been to one since it''s not something I can afford I do not have health insurance I will be contacting pharmacy to ask questions
CDC Split Type:

Write-up: Almost immediately I felt off after the vaccine I wanted to get it to protect my son since I work in a public place not even an hour after I got it I fell asleep unable to keep my eyes open I thought it was okay but here it is Friday and I''m still having trouble staying awake ill be okay for a few hours at a time then have a uncontrollable need to sleep I never ever nap in the daytime and im a very energetic person but I can seem to wake up for more than a little at a time I have to fight it for work but fined myself dozing off standing up I just wanted to report this for it to be known I hope the feeling goes away I really wanna have high hopes for this vaccine


VAERS ID: 1217575 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210422536

Write-up: INJECTION SITE REDNESS; This spontaneous report received from a consumer concerned a 28 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced injection site redness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from injection site redness. This report was non-serious.


VAERS ID: 1217652 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Head discomfort, Headache, Myalgia, Nausea, Pyrexia, Swelling, Swelling face, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 5-hydroxytryptophan, Thyroid Glandular, Magnesium
Current Illness:
Preexisting Conditions: hypothyroidism
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Evening of Day 1, shaking chills, fever (100), headache. Went to bed at 9:00, woke at 3am with severe "swelling" I felt like my brain was too big for my skull, my entire face felt swollen. Joint aches, muscle aches, nausea. Nausea has been intermittent thru day 5. Headache continues but not as severe. I still wake up with it every day (this is now day 5). Diarrhea began on Day 3 (watery, every 1/2 hour for 4 hours). fever subsided and returned on Day 3 (100). no fever since but muscle aches, headache and joint aches continue.


VAERS ID: 1217711 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210422819

Write-up: HALF DOSE ADMINISTERED; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported .The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-APR-2021, the subject experienced half dose administered. The outcome of half dose administered was not reported. This report was non-serious.


VAERS ID: 1217734 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Contusion, Hyperhidrosis, Pyrexia, Rash pruritic, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210423007

Write-up: RASH AND ITCHING ALL OVER ARMS AND SPREAD OVER CHEST; FEELING HOT AND NIGHT SWEATS; ARM SWELLING; ARM BRUISING; FEVER; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. 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, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 12-APR-2021, the subject experienced rash and itching all over arms and spread over chest. On 12-APR-2021, the subject experienced feeling hot and night sweats. On 12-APR-2021, the subject experienced arm swelling. On 12-APR-2021, the subject experienced arm bruising. On 12-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101 F. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, arm swelling, rash and itching all over arms and spread over chest, feeling hot and night sweats, and arm bruising. This report was non-serious.


VAERS ID: 1217738 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic; Drug allergy; Non-smoker
Preexisting Conditions: Comments: patient had no drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210423046

Write-up: INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 65 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included alcoholic, and drug allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 13:10 for prophylactic vaccination. Concomitant medications included naproxen. On 12-APR-2021 13:15, the subject experienced injection site pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from injection site pain. This report was non-serious.


VAERS ID: 1217754 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210423785

Write-up: BODY ACHES; DIARRHEA; FEVER; TIREDNESS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-APR-2021, the subject experienced body aches. On 12-APR-2021, the subject experienced diarrhea. On 12-APR-2021, the subject experienced fever. On 12-APR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, body aches, tiredness and diarrhea was not reported. This report was non-serious.


VAERS ID: 1217759 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seafood allergy; Shellfish allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210423847

Write-up: HEADACHE; This spontaneous report received from a consumer concerned a 22 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seafood allergy, and shellfish allergy.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, administered on 12-APR-2021 12:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache. This report was non-serious.


VAERS ID: 1217775 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Headache, Injection site pain, Injection site rash, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Environmental allergy; Seasonal allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210423862

Write-up: CHILLS; NOT FEELING WELL; MUSCLE ACHES; HEADACHE; FEVER; PAIN AT INJECTION SITE; INJECTION SITE RASH; This spontaneous report received from a consumer concerned a 41 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included environmental allergy, and seasonal allergy.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: not reported) dose was not reported, administered on 12-APR-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced injection site rash. On 12-APR-2021, the subject experienced pain at injection site. Laboratory data included: Body temperature (NR: not provided) 101 F. On 12-APR-2021 17:00, the subject experienced chills. On 12-APR-2021 17:00, the subject experienced not feeling well. On 12-APR-2021 17:00, the subject experienced muscle aches. On 12-APR-2021 17:00, the subject experienced headache. On 12-APR-2021 17:00, the subject experienced fever. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from injection site rash on 13-APR-2021, was recovering from pain at injection site, had not recovered from not feeling well, muscle aches, headache, and chills, and the outcome of fever was not reported. This report was non-serious.


VAERS ID: 1217779 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210423883

Write-up: WARM TO THE TOUCH ON INJECTION SITE; PAIN ON INJECTION SITE; SWOLLEN INJECTION SITE; REDNESS ON INJECTION SITE; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 041A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced warm to the touch on injection site. On 12-APR-2021, the subject experienced pain on injection site. On 12-APR-2021, the subject experienced swollen injection site. On 12-APR-2021, the subject experienced redness on injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain on injection site, warm to the touch on injection site, swollen injection site, and redness on injection site. This report was non-serious.


VAERS ID: 1217789 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Abdominal distension, Infrequent bowel movements
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy; Type II diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: Hip replacement; Rotator cuff tear; Comments: The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210423945

Write-up: STOMACH FEELS FULL; NO BOWEL MOVEMENT FOR 2 DAYS; This spontaneous report received from a patient concerned a 74 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included left rotator cuff tear, and hip replacement, and concurrent conditions included type 2 diabetes, no alcohol use, non smoker, and penicillin allergy, and other pre-existing medical conditions included patient had no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042a21a, expiry: 21-JUN-2021) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced no bowel movement for 2 days. On an unspecified date, the subject experienced stomach feels full. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from no bowel movement for 2 days, and the outcome of stomach feels full was not reported. This report was non-serious.


VAERS ID: 1217834 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-29
Onset:2021-04-12
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Ecchymosis, Full blood count, International normalised ratio increased, Metabolic function test, Oedema peripheral, X-ray
SMQs:, Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: asa 81mg daily, benztropine 2mg bid, clonazapam 0.5mg tid, mirtazapine 15mg daily, quetiapine 50mg, bid, fluphenazine 10mg hs, fluphenazine 10mg bid
Current Illness: None
Preexisting Conditions: EPS, OP, paranoid schizophrenia, heart dz, aphasia
Allergies: NKA
Diagnostic Lab Data: See above.
CDC Split Type:

Write-up: Noted to develop ecchymotic area with swelling to R upper thigh with no adverse events noted or reported. X-rays completed 4/13, CBC, CMP, PTT, PT INR completed 4/14. No abnormal results. Daily ASA on hold, eliquis 2.5mg bid started, frequent monitoring in place. Repeat labs 4/16 and 4/19.


VAERS ID: 1217923 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-04
Onset:2021-04-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Back pain, Chest pain, Fatigue, Headache, Liver function test, Painful respiration, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: busPIRone (BUSPAR) 15 MG tablet FLUoxetine (PROZAC) 20 MG capsule 20 mg, Daily ipratropium-albuteroL (COMBIVENT RESPIMAT) 20-100 mcg/actuation Mist inhaler 1 puff, 4 times daily nystatin (MYCOSTATIN) 100,000 unit/gram top
Current Illness: none
Preexisting Conditions: Cubital tunnel syndrome on left Bulimia Neuropathy PTSD (post-traumatic stress disorder) Insomnia Hyperhidrosis GERD (gastroesophageal reflux disease) Elevated liver function tests Class 2 obesity due to excess calories without serious comorbidity with body mass index (BMI) of 39.0 to 39.9 in adult Candidiasis of breast Acute recurrent maxillary sinusitis
Allergies: penicillins
Diagnostic Lab Data: n./a
CDC Split Type:

Write-up: Obtained J&J vaccine on 4/4/21 Signs/symptoms started 4/12 and continue today Has intermittent severe headache that ranges in pain from 2-7/10 Current pain is 2/10 Intermittent abdominal pain that radiates to back Pain is mainly in shoulder blades just under her bra line Hurts when she takes a deep breath in Pain rated at 2/10 current but can range as high as 7/10 at times Denies Shortness of breath or difficulty breathing or speaking, states pain only when taking in deep breathing Sometimes the pain will shoot down her back to her hips Intermittent pain across the front of her upper chest States she does not know how to describe it but it is not severe Sore all over Fatigued Afebrile


VAERS ID: 1217949 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Gait disturbance, Tendon pain
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Drug allergy; Hay fever; Non-smoker
Preexisting Conditions: Comments: Does not abuse drug or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210423997

Write-up: ACHILLES HEEL IS FEELING SORE; LIMPING; This spontaneous report received from a patient concerned a 51 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included no alcohol user, non smoker, hay fever allergy, and allergic to Dilantin, and other pre-existing medical conditions included does not abuse drug or illicit drug use. The patient was previously treated with phenytoin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A, and expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced Achilles heel is feeling sore. On 12-APR-2021, the subject experienced limping. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from Achilles heel is feeling sore, and limping. This report was non-serious.


VAERS ID: 1217969 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, SARS-CoV-2 test negative
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test negative; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210424197

Write-up: CHILLS; HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not 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, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-APR-2021 13:00, the subject experienced chills. On 12-APR-2021 13:00, the subject experienced headache. Laboratory data (dates unspecified) included: COVID-19 virus test negative (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, and headache. This report was non-serious.


VAERS ID: 1217975 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Feeling abnormal
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424254

Write-up: NO POWER TO GET OUT OF BED; FEELING TERRIBLY BAD; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 12-APR-2021, the subject experienced feeling terribly bad. On 13-APR-2021, the subject experienced no power to get out of bed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feeling terribly bad, and no power to get out of bed. This report was non-serious.


VAERS ID: 1217987 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: Body temperature; Result Unstructured Data: 100 (unit not reported)
CDC Split Type: USJNJFOC20210424445

Write-up: CHILLS; LITTLE BIT OF NAUSEA; HEADACHE; FEVER; This spontaneous report received from a consumer concerned a 20 year old female. The patient''s weight, height, and medical history were not 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, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced little bit of nausea. On 12-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 100 (unit not reported). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from little bit of nausea, and had not recovered from chills, headache, and fever. This report was non-serious.


VAERS ID: 1217990 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424485

Write-up: PAIN ALL OVER THE BODY; FEVER; CHILLS; VOMITING; This spontaneous report received from a consumer concerned a 32 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and batch number: 207A21A expiry: 23-JUN-2021) dose was not reported, administered on 12-APR-2021 10:48 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced pain all over the body. On 12-APR-2021, the subject experienced fever. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced vomiting. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vomiting on 12-APR-2021, and had not recovered from pain all over the body, fever, and chills. This report was non-serious.


VAERS ID: 1217993 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Mississippi  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424504

Write-up: FELT WARM; CRAMPS IN LEG AND BUTT AREA; This spontaneous report received from a parent concerned an 18 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 12:45 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced cramps in leg and butt area. Treatment medications included: acetylsalicylic acid/caffeine. On 13-APR-2021, the subject experienced felt warm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from cramps in leg and butt area, and had not recovered from felt warm. This report was non-serious.


VAERS ID: 1218003 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Headache
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPRIN; KEPPRA; CITALOPRAM
Current Illness: Cough; Epilepsy
Preexisting Conditions: Medical History/Concurrent Conditions: Bruising; Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424658

Write-up: BRUISING IN RIGHT ARM; SLIGHT HEADACHE; This spontaneous report received from a patient concerned a 60 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included epilepsy, bruising, and cough.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, and batch number: 043A21A expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. Concomitant medications included citalopram for epilepsy, levetiracetam for epilepsy, and acetylsalicylic acid. On 12-APR-2021, the subject experienced slight headache. Treatment medications included: ibuprofen. On 13-APR-2021, the subject experienced bruising in right arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from slight headache on 12-APR-2021, and had not recovered from bruising in right arm. This report was non-serious.


VAERS ID: 1218013 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A211A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Influenza like illness, Sleep disorder
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL EXTRA-STRENGTH
Current Illness: Herniated disc; Nerve pain
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424853

Write-up: FLU-LIKE SYMPTOMS; LACK OF SLEEP; LOW GRADE HEADACHE; TIREDNESS; This spontaneous report received from a patient concerned a 56 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included herniated disc, and nerve pain, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A211A, and batch number: 207A211A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. Concomitant medications included paracetamol for nerve pain, and herniated disc. On 12-APR-2021, the subject experienced flu-like symptoms. On 12-APR-2021, the subject experienced lack of sleep. On 12-APR-2021, the subject experienced low grade headache. On 12-APR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu-like symptoms on 13-APR-2021, had not recovered from low grade headache, and tiredness, and the outcome of lack of sleep was not reported. This report was non-serious.


VAERS ID: 1218014 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Chills, Hyperhidrosis, Off label use, Pain, Product administered to patient of inappropriate age, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: Patient had no known drug allergies or drug abuse/illicit drug usage. Patient denied history of reactions to vaccines.
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210424899

Write-up: PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE; OFF LABEL USE; GENERALIZED WEAKNESS; ACHY; SWEATING; CHILLS; FEVER; This spontaneous report received from a patient concerned a 16 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 patient had no known drug allergies or drug abuse/illicit drug usage. patient denied history of reactions to vaccines. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: 23-JUN-2021) dose was not reported, administered on 12-APR-2021 12:45 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced sweating. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101 F. On 12-APR-2021 21:00, the subject experienced achy. On 12-APR-2021 21:00, the subject experienced generalized weakness. On an unspecified date, the subject experienced product administered to subject of inappropriate age, and off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from achy, generalized weakness, fever, chills, and sweating, and the outcome of product administered to patient of inappropriate age and off label use was not reported. This report was non-serious.


VAERS ID: 1218031 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PREDNISOLONE
Current Illness: Sinus headache
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210425272

Write-up: HEADACHE; This spontaneous report received from a consumer concerned a 63 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included occasional sinus headache on and off. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. Concomitant medications included prednisolone. On 12-APR-2021, the subject experienced headache. Treatment medications (dates unspecified) included: guaifenesin/paracetamol/phenylephrine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of headache was not reported. This report was non-serious.


VAERS ID: 1218128 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Feeling abnormal, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Did not seek treatment, rested until symptoms subsided
CDC Split Type:

Write-up: Flu-like symptoms for two days after receiving vaccine, including body aches, extreme fatigue, 100.3 fever on day after vaccine, diarrhea on second day after vaccine. General brain-fog


VAERS ID: 1218179 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Body temperature increased, Chills, Headache, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Received shot around 10:00am April 12th, by 12:00pm (beginning of work shift)I experienced a headache and took Advil, figured it was menstrual related since it started the same day. By 5:00 my body started to feel aches and chills but was very mild. By 5:30-5:45 I took a midal for the pain I was experiencing, more severe muscle/ back aches and chills. By 6:30 I went home early from work because symptoms were getting worse and it was hard to continue my shift. Once arriving home around 8 pain continue to progress but I figured I just needed to lay down and rest. By 9 I had soup but could barley finish due to pain. I continued to monitor my temperature because I was experiencing chills even though I had my heater on etc. by 10:00-10:30 my temperature went all the way up to 101.2 and I was concerned so I called 911. They sent an ambulance to come take me to the hospital. On the way there I believe my temperature went down. The paramedics took my temp and it was 99.5 before they took me to the hospital. And when the nurses took my temperature it was 97.8. This happened in the course of about 30-40 minutes of my phone call and arriving to the hospital. Either way I was concerned about the pain because I know there would be symptoms following the shot but I didn?t think it would be so severe. After waiting to be checked in and evaluated they proscribed me Tylenol and ibuprofen. But at a location that was closed for the day. I asked if I could just take more pain killers for the pain (midal and Advil) and I was told i could. Once arriving home by 11:30 I took two midal pills and the pain reduced within an hour. So I was able to sleep. The next day I still experienced pain but took pain killers to help with it.


VAERS ID: 1218285 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-31
Onset:2021-04-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

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

Write-up: THE PATIENT WAS SEEN FOR CHEST PAIN, CHEST PRESSURE, AND SHORT OF BREATHE. THE PATIENT WAS GIVEN A CHEST XRAY AND AN EKG. THEY WERE BOTH CLEAR. THE PATIENT WAS ALSO GIVEN A COVID RAPID TEST WHICH RESULTED AS A NEGATIVE. THE PATIENT WAS THEN RECCOMENDED TO GO TO THE NEAREST EMERGENCY DEPARTMENT TO OBTAIN FURTHER TESTING AND HE REFUSED - SIGNING A AMA.


VAERS ID: 1218373 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: scratchy throat, concerned for allergic reaction , none identified by ems personnel


VAERS ID: 1218409 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Oropharyngeal discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

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

Write-up: numbness left side of face, tightness of throat , throat scratchy


VAERS ID: 1218436 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-03
Onset:2021-04-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Dysmenorrhoea, Menstruation irregular
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad)

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

Write-up: Severe menstrual cramps and GI distress during period, abnormally light flow.


VAERS ID: 1218522 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Occasional 1-2 glasses per week.); Fruit allergy; Non-smoker
Preexisting Conditions: Comments: The patient was not pregnant at the time of reporting. The patient had no history of drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210425467

Write-up: INTENSIFIED BODY ACHES; CHILLS; NAUSEA; This spontaneous report received from a patient concerned a 35 year old female. The patient''s weight was 160 pounds, and height was 62 inches. The patient''s concurrent conditions included coconut allergy, alcohol user, and non-smoker. The patient was not pregnant at the time of reporting. The patient had no history of drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042a21a, expiry: 21-JUN-2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced intensified body aches. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, intensified body aches, and nausea. This report was non-serious.


VAERS ID: 1218530 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chills, Headache
SMQs:, Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210425845

Write-up: ANXIETY; CHILLS; THROBBING HEADACHES; This spontaneous report received from a parent concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 12-APR-2021, the subject experienced anxiety. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced throbbing headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the throbbing headaches, chills and anxiety was not reported. This report was non-serious.


VAERS ID: 1218548 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427161

Write-up: NUMBNESS OF THE EARS AND FACE (LEFT SIDE); This spontaneous report received from a pharmacist concerned a patient of unspecified age. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced numbness of the ears and face (left side). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from numbness of the ears and face (left side). This report was non-serious.


VAERS ID: 1218549 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427164

Write-up: SHARP JABBING PAIN IN BODY; FEELING LIKE STICKING WITH NEEDLE ALL OVER; This spontaneous report received from a consumer concerned a 64 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced sharp jabbing pain in body. On 12-APR-2021, the subject experienced feeling like sticking with needle all over. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the sharp jabbing pain in body and feeling like sticking with needle all over was not reported. This report was non-serious.


VAERS ID: 1218556 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427279

Write-up: HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache. This report was non-serious.


VAERS ID: 1218623 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax, Dyspnoea, Fibrin D dimer, Full blood count, Lymphadenopathy, Metabolic function test, Nausea, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 4/14/2021 - D-Dimer... 0.57 4/15/2021 - CMP....Chloride 108 otherwise WNL 4/15/2021 - CBC....WNL 4/15/2021 - Covid Antigen....negative 4/15/2021 - CT Chest PE protocol....1. No pulmonary emboli. 2. Nonspecific bilateral poorly defined areas of groundglass infiltrate in both lungs. Considerations would include inflammation, infection or edema.
CDC Split Type:

Write-up: 4/14/2021 - Patient received shot on 4/9 in left arm at an off site vaccination clinic. Developed 102 temp and some nausea. By 4/12 developed SOB and sore nodules above her collarbone on left side, but no injection site hurting or redness. Testing as done below and patient sent home with ProAir HFA and Doxycycline 100 mg bid x 7 days. Assessments: 1. Lymph node enlargement. 2. SOB Follow up 4/22/2021


VAERS ID: 1218636 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Confusional state, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft; Trazodone; Progestin; Pantoprazole
Current Illness: None
Preexisting Conditions: Unspecified autoimmune disorder; asthma; anxiety
Allergies: Doxycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9 hours post injection patient started chills; fever rose to 104.9 - was brought below 104 with acetaminophen. Fever, chills, body aches, severe headache, mental confusion lasted until 48 hours post injection and then subsided.


VAERS ID: 1218644 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Headache, body aches, fatigue, chills, nausea


VAERS ID: 1218675 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Nausea, Vital signs measurement, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Pt became nauseated following vaccination, patient vomited. Pt diaphoretic, face flushed, vitals checked, cool cloth placed on back of neck


VAERS ID: 1218678 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: miralax, zyrtec, singulair, asetlin nasal spray, hydrocortisone cream, wellbutrin, estradiol vaginal insert, levothyroxine, flonase
Current Illness: sinus infection (deemed viral)
Preexisting Conditions: hypothyroidism, allergies, non hodgkins lymphoma (remission), depression
Allergies: bee stings, peanut butter, several trees/grasses esp in fall/spring
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Hives began on the right arm 3 days after vaccination. The next morning (day 4) the hives/welts had spread all over but would come and go mostly where her clothes would rub or where there was any kind of heat (like under arm area). The hives eventually moved down to her feet on day 7. The patient is still reporting hand sensitivity/itching if exposed to heat. The patient was prescribed pepcid, steroid shot, and prednisone taper. She is also using topical hydrocortisone cream. The steroid injection has helped with symptom management per the patient. (patient is also getting allergy injections and had received her allergy injection about 3 weeks before her covid vaccine)


VAERS ID: 1218691 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: On 4/16/2021 patient reported left leg pain began on 4/12/2021. Pharmacist recommended the patient seek medical attention at the nearest emergency room.


VAERS ID: 1218704 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax normal, Feeling jittery
SMQs:

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

Write-up: Patient was admitted due to feeling jittery, with history of seizure, possible non-compliance. Dose of Keppra increased, chest imaging negative for pneumonia.


VAERS ID: 1218743 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot, Headache, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Strong headaches, sleeping hands
Other Medications: Levothyroxine75 mcg Atorvastatin 20 mg Gemfibrozil 600 mg
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: No
CDC Split Type:

Write-up: On the day of the vaccine just a lot of heat in the body at night and sleeping hands. Severe legs pain and headache on 4/12/21 Started early in the morning but then disappeared.


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