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

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



Case Details

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VAERS ID: 1406337 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-27
Onset:2021-06-10
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Dizziness, Dyspnoea, Pain in extremity, Palpitations, Peripheral swelling, Pulmonary embolism, Pulmonary thrombosis, Thrombosis, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan
Current Illness: None
Preexisting Conditions: HBP
Allergies: None
Diagnostic Lab Data: I had four sonography done. Three for leg and one for heart. Results: Bilateral pulmonary embolism (CMS-HCC) (126.99) Acute Deep Vein thrombosis (DVT) of popliteal vein of left lower extremity (CMS-HCC) (182.423)
CDC Split Type:

Write-up: That day, light headed ness and heart palpitations. Heart palpitations for short time only but felt periodically over the next few days. June 11, lower left led swelled and painful and shortness of breath. June 14, went to ER. They found multiple blood clots in upper thigh, behind knee and lower left leg. They also found approximately 20 clots in the lungs and administered Heparin drip and I was impatient. They put me on Eliquis and released me the next day. Now convalescing at my daughter?s house. Diagnosis. Acute Deep Vein Thromboses and Pulmonary Embolism bilateral.


VAERS ID: 1406618 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Anticoagulant therapy, Aspartate aminotransferase increased, Blood albumin normal, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Calcium ionised decreased, Deep vein thrombosis, Full blood count, Globulins decreased, Haematocrit normal, Haemoglobin normal, Joint range of motion decreased, Mean cell volume increased, Metabolic function test, Muscle spasms, Neutrophil percentage increased, Pain in extremity, Peripheral swelling, Platelet count decreased, Protein total normal, Skin warm, Ultrasound Doppler abnormal, White blood cell count normal
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO 10MG, rivaroxaban 20 mg Tab, esomeprazole 40 mg, tadalafiL 10 mg Tab, c-pap, amLODIPine 5 mg Tab
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Results from the first ultra sound on 5/20/2021: Left lower extremity deep venous thrombosis. The results were communicated to the referring physician by the sonographer. The patient was sent from the radiology department to the referring physician''s office. Narrative History: Left leg pain and swelling. Study: Left lower extremity venous duplex ultrasound with color Doppler imaging and spectral analysis. Comparison: 0 Findings: The deep venous structures of the left lower extremity, common femoral vein distally extending into the calf veins, are evaluated. There is occlusive and nonocclusive thrombus extending from the calf veins superiorly into the mid aspect of the superficial femoral vein. Results from the second ultra sound on 6/07/2021 IMPRESSION: 1. There is persistent occlusive deep venous thrombosis within the mid to distal superficial femoral vein extending nonocclusive bleed to involve the popliteal vein and exclusively within the proximal popliteal and peroneal veins of the calf. Significant interval change since comparison evaluation is not identified. No interval progression. Narrative HISTORY: DVT. COMPARISON: 20 May 2021 FINDINGS: Real time color Doppler imaging and spectral analysis were performed during ultrasound evaluation of the left lower extremity is performed. There is persistent occlusive deep venous thrombosis within the mid to distal superficial femoral vein extending nonocclusive bleed to involve the popliteal vein and exclusively within the proximal popliteal and peroneal veins of the calf. Significant interval change since comparison evaluation is not identified. No interval progression.
CDC Split Type:

Write-up: In March I had a pain in my left calf muscle that I could not identify with getting hit or injuring it in any way. I called Urgent care because i read and heard about problem with the J&J vaccine that it was giving people blood clots. Urgent care said there was no need to come in that there was very little reason to believe that it was a blood clot. Then in June I woke up to very severe pain in my left leg from my foot all the way to my thigh. It was hot, swollen and I could barely bend my knee. I went to Urgent Care and they sent me across the street to the Hospital for an ultra sound on my leg. Here are the result from the ultra sound. Real time color Doppler imaging and spectral analysis were performed during ultrasound evaluation of the left lower extremity is performed. There is persistent occlusive deep venous thrombosis within the mid to distal superficial femoral vein extending nonocclusive bleed to involve the popliteal vein and exclusively within the proximal popliteal and peroneal veins of the calf. The doctor put me on 3 week of taking a blood thinner twice a day and then will go down to taking one blood thinner once a day for 6 months. I also saw MD. Here are his notes from my Drs appt. Patient is seen today, 6/14/2021, to discuss management of left leg DVT. Patient presented to urgent care on 5/20/2021. He had noticed soreness in his left leg for a couple of days and then he awoke that day and the leg was swollen. The duplex scan showed that he had occlusive clot involving left superficial femoral vein extending through popliteal vein down to peroneal vein in the left calf. He was started on rivaroxaban 15 mg twice daily. He transitions to 20 mg rivaroxaban daily tomorrow. The leg soreness has eased slightly but the swelling has not improved. He did have a repeat duplex scan on 6/7/2021 which was unchanged. Thrombus persisted but was not worse. He has not had chest pain or breathing issues or dyspnea. He does recall that about 4 weeks earlier he had a muscle spasm sensation in the left calf. He had received a Johnson & Johnson Covid immunization in late February, 2021. He was aware of the public information about venous clotting in women who had received the J&J vaccine and was also aware that it involved cerebral veins. He called his provider and was asked questions about the leg and otherwise the answers were negative. So imaging was not obtained. The muscle spasm sensation did not recur. His family history is negative for clots in his personal history for clots is otherwise negative. He is a maintenance manager. He has not had lengthy travel recently. He also denies any trauma to the legs. He has a history of GERD from which she had developed iron deficiency anemia in June 2020. He had undergone EGD has a result. He also had a colonoscopy when he turned 50 years of age and had polyps removed and then had repeat colonoscopy 6 months later. This evaluation occurred with Dr. of gastroenterology. His colonoscopy was on 12/20/2018. One of the polyps was a hyperplastic polyp. The second was a tubulovillous adenoma with high-grade dysplasia/intramucosal adenocarcinoma, 2 cm size. Polyps were excised. Had repeat endoscopy on 7/10/2019 he had a hyperplastic polyp in his rectum. Also he had a PSA checked in summer 2020. It was 0.5. He is a smoker only of very infrequent cigars, perhaps every 6 to 8 months. PAST MEDICAL HISTORY: GERD Sigmoid colon polyps, resected December 2018 and June 2019 Left leg DVT, May 2021 Sleep apnea Iron deficiency anemia related to gastritis. Diagnosed June 2020, treated with oral iron ADHD History of depression MEDICATIONS: has a current medication list which includes the following prescription(s): amlodipine, escitalopram, esomeprazole, multivit-iron-fa-calcium-mins, prednisone, rivaroxaban, unknown home medication, and tadalafil. ALLERGIES: Patient has no known allergies. PAST SURGICAL HISTORY: Vasectomy 2 colonoscopies, first in December 2018 and second in July 2019 EGD on 2 occasions, first in March 2019 and second in June 2020 FAMILY HISTORY: Father died age 66. He had a pacemaker and was on blood thinners Mother died of a throat cancer. She was a heavy smoker. Died at age 60 1 brother and 1 sister are healthy SOCIAL HISTORY: Smokes cigars, perhaps twice a year. Never smoked cigarettes Alcohol use maybe 4 beers on the weekend Previously married and divorced 3 children, 2 daughters and 1 son ranging in age from 17 through 21 REVIEW OF SYSTEMS: Significant for persistent soreness in his left leg albeit easing over the last 3 days and persistent swelling in his left leg including dorsum of his foot General: Denies weight loss, no issues with energy, denies night sweats HEENT: No mouth or throat soreness, no issues with hearing, no tinnitus, no issues with taste No epistaxis Resp: Denies cough, exertional dyspnea, sputum production. Heart: No palpitations, no exertional chest pain, no lightheadeness or dizziness when standing Gi: No dysphagia. No heartburn, Denies nausea or vomitting. Bowels are regular, no diarrhea or constipation. Denies melena or hematochezia GU Denies hematuria. No dysuria. No incontinuence. Skin: No rash, no petechiae, no dryness. No itching or burning. Musculoskeletal: No bone pains, no joint pains or swelling. No localized weakness Neurologic: Denies headaches, no double vision, no weakness, no change in sensation Psychiatric: Good spirits, sleeping well, no anxiety, normal mood Endocrine: Denies heat or cold intolerance. Heme: No easy bruising PHYSICAL EXAMINATION: BP (!) 142/99 | Pulse 95 | Temp 97.6 ?F (36.4 ?C) | Resp 18 | Ht 6'' 3" (1.905 m) | Wt 295 lb (133.8 kg) | SpO2 96% | BMI 36.87 kg/m? Appears alert, oriented, not in distress. Well developed Psychiatric: Patient is alert oriented ?4, good spirits, interacts appropriately He has swelling in his left leg DATA: CBC: .5/20/2021: WBC 7.49 X10^3/uL; Hemoglobin 14.8 g/dL; Hematocrit (calc.) 43.4 %; Neutrophil (%) 75.4 %; MCV 98.4 fL; Platelet 141 X10^3/uL* CMP: 4/22/2021: Bicarbonate (TCO2) 25 mmol/L; BUN/Creatinine 16; Calcium, total 9.0 mg/dL; AST (SGOT) 41 IU/L*; ALT (SGPT) 38 IU/L; Alkaline Phosphatase 62 IU/L; Bilirubin, Total 0.4 mg/dL; Protein, total 6.9 g/dL; Albumin 4.3 g/dL; Albumin / Globulin 1.7 5/20/2021: Sodium 142 mEq/L; Potassium 4.6 mEq/L; Chloride 103 mEq/L; BUN 13 mg/dL; Creatinine 1.2 mg/dL; Glucose 110 mg/dL*; Calcium, Ionized 1.17 mmol/L ASSESSMENT: 1. Left lower extremity DVT. Etiology unclear. No definite provocation. He did receive a Johnson & Johnson Covid vaccine in late February, 2021. He first noticed a muscle spasm sensation in left calf in mid April, 2021 and then had onset of soreness 2 days before his visit with swelling onset the day of his urgent care visit, 5/20/2021. Currently on rivaroxaban. Transitioning now to the 20 mg daily dose. Family history negative for DVT as is his personal history. PSA was unremarkable and summer 2020. Has had prior colonoscopy in December 2018 and June 2019. Did have finding of sigmoid colon polyps with atypia in 1 and possible noninvasive adenocarcinoma. Repeat scope showed hyperplastic polyp but no additional polyps. Has also had EGDs in March 2019 and June 2020 because of GERD and iron lack anemia. Non-smoker. I discussed with patient that we would usually treat him for 6 months with anticoagulation and then reassess to determine whether it is safe to discontinue therapy. But if he has ongoing swelling and soreness in his leg it would be difficult to stop treatment because we would lose one of our early indicators of recurrence of DVT. I also suggested that we should do a lab panel to assure that he does not have any underlying inherited or acquired abnormality that predispose to this clot, since we do not have any clear-cut causative etiology. (We discussed that the Covid immunization may have been his predisposition, but that existing data suggest that this is a risk factor in females and that most of the episodes were central nervous system venous clots.) PLAN: 1. So we will draw lab panel assessing acquired and inherited predispositions for hypercoagulability. And we will plan to see him back in a couple of months to reassess his status.


VAERS ID: 1406746 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose, Cold sweat, Dizziness, Electrocardiogram, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Admitted to Emergency Room on 6/1/2021 at approximately 6:15 PM, EKG as well as blood glucose test performed.
CDC Split Type:

Write-up: Patient (myself) experienced lightheadedness, blurred/starry vision, clammy palms, intense cold sweat and almost fainted approximately 10-15 minutes after receiving Janssen COVID19 vaccine injection. I was provided a small bag of cookies and a bottle of water while sitting in a chair. These symptoms manifested a second time approximately 10 minutes after the first on-set and I was laid on the floor with feet elevated.


VAERS ID: 1406752 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-05-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Vestibular disorders (broad)

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

Write-up: severe headache 2 weeks later, dizzy spells for about a week. Had a CT scan and found out it was a stroke.


VAERS ID: 1406792 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-06-15
Onset:2021-06-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 UN / IM

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

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

Write-up: transported to ER, fluids given


VAERS ID: 1407106 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-05
Onset:2021-04-24
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Headache, Heavy menstrual bleeding, Mobility decreased, Pain in extremity, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Mild asthma, migraine headaches, I carry an epi pen due to anything that contains venom (bees, wasps and hornets) I get anaphylactic shock
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: On 04-24-2021 I had four days of extreme headaches that would not go away so I went to the ER where I got checked out. Also on 03-28-2021, I woke up with extreme left leg pain. I had difficulty holding things with my arms and I almost collapsed to the floor due to my left leg pain and weakness. I also had heavy menstrual bleeding with giant clots for the Month of March 2021. I can say today I have no symptoms of my left leg or headaches today.


VAERS ID: 1407133 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-08
Onset:2021-04-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blindness unilateral, Cerebrovascular accident, Computerised tomogram 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), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN, OMEPRAZOLE, LOSARTAN, ATORVASTATIN, SPIRONOLACTONE AND SERTALINE
Current Illness:
Preexisting Conditions: DIABETES, HIGHBLOOD PRESSURE, CHOLESTROL , ACID REFLUX AND ANXIETY
Allergies: IBUPROFEN, AND ASPIRIN
Diagnostic Lab Data: SEE ABOVE
CDC Split Type:

Write-up: ON APRIL 16, 2021 I WOKE UP AND I COULDN''T SEE OUT OF MY LEFT EYE, I WAITED A WHILE TOO SEE IF MY SIGHT WILL COME BACK AND IT DIDN''T SO I CALLED MY EYE DOCTOR AND MADE APPOINTMENT AND THEY SCHEDULED ME FOR APRIL 23, 2021. A WEEK LATER I WENT BACK TO THE DOCTOR AND HE TOLD ME TOO GO TO HOSPITAL A.S.A.P. THEY TOOK A CAT SCAN AND SAW THE OPHTAQLMOLOGIST IN HOSPITAL THE DIAGNOSIS WAS A BLOOD CLOT IN MY LEFT EYE AND I TOOK A STROKE.


VAERS ID: 1407202 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-24
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet,delayed release Take 1 tablet every day by oral route. baclofen 10 mg tablet TAKE ONE TABLET BY MOUTH FOUR TIMES A DAY cilostazoL 50 mg tablet TAKE ONE TABLET BY MOUTH TWICE A DAY Eliquis 5 mg tablet TAKE ONE TABL
Current Illness: none
Preexisting Conditions: chronic obstructive lung disease J44.9 Chronic obstructive pulmonary disease, unspecified dx 2015, oxygen dependent congestive heart failure I50.9 Heart failure, unspecified dx 2016, s/p heart valve repair coronary artery bypass graft 2016 coronary atherosclerosis I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris dx 2015 dependence on supplemental oxygen Z99.81 Dependence on supplemental oxygen sx 2015, oxygen dependent essential hypertension I10 Essential (primary) hypertension dx 2015 fall Left hip pain hernia of anterior abdominal wall K43.9 Ventral hernia without obstruction or gangrene history of aortic valve repair Z98.890 Other specified postprocedural states 2016, aortic stenosis, s/p aortic valve repair history of Deep vein thrombosis dx 2017, left hyperlipidemia E78.5 Hyperlipidemia, unspecified dx 2015 nodule of lung CT- 5 mm R lung pulmo nodule,4/27/2021 paroxysmal atrial fibrillation on Eliquis 5mg, q12h for a/c peripheral vascular disease I73.9 Peripheral vascular disease, unspecified dx 2015, maintained on Cilostazol repair of aneurysm of abdominal aorta 2015 screening for malignant neoplasm of colon Z12.11 Encounter for screening for malignant neoplasm of colon sleep apnea G47.30 Sleep apnea, unspecified dx 2015, maintained on CPAP
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bell''s palsy Right. since April 24,2021 He was seen at MEDICAL CENTER, s/p acyclovir, prednisone treatment. pt. states 50% improving It was noted that he had J&J Covid19 vaccine. Pt. advised to report it to Vsafe. It will also be reported to VAERS.


VAERS ID: 1407620 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-12
Onset:2021-06-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Computerised tomogram head abnormal, Condition aggravated, Contusion, Dizziness, Ear haemorrhage, Haematotympanum, Headache, Hypoacusis, Loss of consciousness, Otorrhoea, Skull fractured base, X-ray limb normal
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No known
Preexisting Conditions: No known
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Johnson & Johnson vaccine on 6/12 @11:03 at the Vaccination Site. Patient started walking to observation area, reported feeling dizzy, lost consciousness, was assisted to the ground by staff at 11:05. When awakened, patient reported right elbow pain, headache, and was found to have a small amount of bleeding from his right ear. No preceding chest pain/palpitations/dyspnea, seizure activity, nor focal weakness. He was transported to the ED via EMS for further evaluation. In the ED patient reported previous history of syncopal episode with preceding dizziness several years ago but did not seek further evaluation. No nausea/vomiting. Evaluation revealed decreased hearing, drainage from ear, and right elbow tenderness. CT of head demonstrated right temporo-parietal bone fracture extending to skull base with blood within right mastoid air cells. Elbow x-ray showed no obvious fracture with right elbow contusion diagnosed. Trauma and neurosurgery further evaluated patient and recommended non-operative management of right temporal skull fracture extending into the auditory canal with no evidence of intracranial bleed nor depression. Hospital consulted and prescribed Ciprodex drops for 1 week with follow-up audiogram in 6 weeks. Patient to follow-up in trauma clinic or with PCP in 2-3 weeks. If hearing still muffled at follow-up, ENT will be consulted. Patient was discharge later in the evening on 6/12/2021.


VAERS ID: 1407680 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-19
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Anticoagulant therapy, Blood test abnormal, Cardiac failure congestive, Cardiomegaly, Catheterisation cardiac normal, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Electrocardiogram abnormal, Fatigue, Hypertension, Infection, Pneumonia, Poor quality sleep, Pulmonary embolism
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 5/13: bloodwork/ECG/CT scan: enlarged heart(pump 22%) pulmonary embolism & hypertension 5/18: cardiac catherization: clear? negative results 5/19: chest X-ray: acute infection in lung 5/13-20: bloodwork just about everyday
CDC Split Type:

Write-up: 12 hrs after vaccinated: loss of taste/smell 4/19-26: fatigue 4/26-5/9: shortness of breath during night.. restless sleep 5/10-13: periodic shortness of breath throughout day 5/13-20: admitted to hospital - pulmonary embolism & congestive heart failure IV treatment: heparin 5 days Several medications each day/night taken


VAERS ID: 1407692 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-06-08
Onset:2021-06-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Atelectasis, Chest pain, Computerised tomogram thorax, Dyspnoea, Lung opacity, Pleuritic pain, Pulmonary embolism, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho Cyclen 0.25/35mg daily
Current Illness:
Preexisting Conditions: Chronic Lymphedema
Allergies:
Diagnostic Lab Data: Results were called to RN at 11:44. Signed by: 6/16/2021 12:29 PM: ******** ORIGINAL REPORT ******** EXAMINATION: CT ANGIOGRAM CHEST W WO CONTRAST 6/16/2021 11:06 AM CLINICAL INDICATION: PE suspected, high prob;;J&J and OCPs, right low chest pain and sob COMPARISON: None available TECHNIQUE: Three-dimensional reconstructions pulmonary artery FINDINGS: There is a single small filling defect in pulmonary artery to the right lower lobe reference axial image 85 through 90. No other pulmonary emboli identified. Thoracic aorta shows nothing acute. No mediastinal or hilar adenopathy. No pericardial or pleural effusion. There are some atelectatic changes in the lung bases. There is some fine groundglass opacity in both lungs greatest inferiorly that is not specific. Its compatible with increased water content of the lungs. No acute osseous abnormality. IMPRESSION: 1. Small right lower lobe pulmonary embolus. 2. Bibasilar pulmonary atelectasis with some groundglass opacity in the lungs compatible with nonspecific increased water content. 3. This report has been designated as having Call Report findings. Signed by: 6/16/2021 11:25 AM:
CDC Split Type:

Write-up: Shortness of breath, pleuritic R lower chest pain since 6/15. Was seen in ED on 6/16 and diagnosed with right lower lobe pulmonary embolism. Then had OCP discontinued, and was started on Xarelto for anticoagulation treatment. Was discharged from ED 6/16. Returned to clnic on 6/17 and still having symptoms of pleuritic chest pain of right lower chest, however does not have SOB or dyspnea on exertion.


VAERS ID: 1407726 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-20
Onset:2021-06-16
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax abnormal, Dizziness, Dyspnoea, Electrocardiogram QT interval, Electrocardiogram abnormal, Fibrin D dimer, Pulmonary embolism, Sinus tachycardia, Troponin increased, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81 mg daily, atorvastatin 40 mg daily, isosorbide mononitrate 30 mg daily, lisinopril 10 mg daily, metolazone 2.5 mg dialy, metoprolol succinate 12.5 mg daily, naproxen 500 mg twice daily, omeprazole 20 mg daily
Current Illness: none
Preexisting Conditions: Chronic systolic congestive heart failure, Frequent PVCs, Impaired glucose tolerance, Hyperlipidemia, Chronic GERD, Essential hypertension
Allergies: Codeine (GI upset)
Diagnostic Lab Data: On admit 6/16/2021 at 2044: Troponin 0.327 (up to 2.050 on 6/17 at 0317), D Dimer 12. EKG in ER showing sinus tachycardia with a ventricular rate of 132 gmp. QTc 477 CTA: moderate volume bilateral pulmonary emboli extending into all lobes of the lung with findings concerning for right heart strain and pulmonary arterial hypertension. Ultrasound Leg Duplex Bilateral: no evidence of DVT (6/17/2021 at 1055)
CDC Split Type:

Write-up: Covid vaccine received on 5/20/2021. Patient went to another state over weekend and reported spending most of Sunday, June 13, 2021 in a vehicle. Patient presented to cardiology outpatient appointment with dyspnea on 6/16/2021. Later that same day was loading hay in very hot weather (around 100 degrees Fahrenheit) and became dizzy. Later, that same day the dizziness remained and new symptoms of chest pain and shortness of breath. Patient presented to ER that evening, and was admitted to the hospital for bilateral pulmonary emboli extending into all lobes of the lungs.


VAERS ID: 1407730 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-20
Onset:2021-06-01
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Back pain, Computerised tomogram thorax abnormal, Fibrin D dimer increased, Myalgia, Pain in extremity, Pulmonary thrombosis, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: D-dimer, ultra sound of all veins in legs, ct scan of chest. Results were a clot in lower right leg, upper left leg above knee, and two bottom of the lungs.
CDC Split Type:

Write-up: Received the J&J vaccine in May 20. Started experiencing leg muscle and back pain June 1, 2021. Progressively got worse over the following weeks. On June 15 I woke up with a new pain in my leg. Went to urgent care and had a D-Dimer test that came out very high. I was sent to ER where they discovered one clot in each leg and two in my lungs via ultra sound and ct scan. I was immediately hooked up to herapin blood thinner through an IV. I was released the following afternoon with Eliquis blood thinner tablets.


VAERS ID: 1407736 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-17
Onset:2021-06-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling hot
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness:
Preexisting Conditions: Arthritis; COVID x2
Allergies: Denies
Diagnostic Lab Data:
CDC Split Type:

Write-up: SOB; dizziness; warmness, tingling on left arm (started before vaccination per patient)


VAERS ID: 1407765 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-21
Onset:2021-06-15
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet apixaban (ELIQUIS) 5 MG TABS tablet Aspirin-Acetaminophen-Caffeine (EXCEDRIN EXTRA STRENGTH PO) cetirizine (ZYRTEC) 10 MG tablet cholecalciferol 50000 units capsule divalproex (DEPAKOTE ER) 500 MG exten
Current Illness: none
Preexisting Conditions: Bipolar disorder, most recent episode manic (HCC) Tobacco use disorder BMI 50.0-59.9, adult (HCC) Generalized anxiety disorder Borderline personality disorder (HCC) Gastroparesis Prehypertension Family history of early CAD Snoring Suspected sleep apnea Mixed incontinence
Allergies: Allergies Amoxicillin Anaphylaxis High Allergy 9/7/2016 Past Updates... Codeine Anaphylaxis High Allergy 8/23/2012 Past Updates... Demerol Anaphylaxis High Allergy 8/23/2012 Past Updates... Morphine Anaphylaxis High Allergy 8/23/2012 Past Updates... Pcn [Penicillins] Anaphylaxis High Allergy 8/23/2012 Past Updates... Erythromycin Rash Low Allergy 8/23/2012 Past Updates... Percocet [Oxycodone-acetaminophen] Rash Low Allergy 12/23/2016 Past Updates... Sulfa Antibiotics Rash Low Allergy 8/23/2012 Past Updates... Adverse Reactions/Drug Intolerances Metoprolol Tartrate Other (See Comments) Not Specified Intolerance 8/22/2018 Past Updates... Lactose
Diagnostic Lab Data: CT scan positive for PE
CDC Split Type:

Write-up: pulmonary embolism, treated with Eliquis


VAERS ID: 1407803 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-09
Onset:2021-05-26
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthropod bite, Biopsy, Dermatitis allergic
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Bupropion
Diagnostic Lab Data: Biopsy 6-10-2021
CDC Split Type:

Write-up: After a tick bite, had an allergic reaction consisting of eczema and psoriasis (biopsy).


VAERS ID: 1407866 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-17
Onset:2021-06-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pharyngeal swelling, Throat irritation, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: pt. injected self with her own epi pen
CDC Split Type:

Write-up: pt. with complaints of throat swelling, feeling of tightness and scratchy, audible expiratory wheezes


VAERS ID: 1407979 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-17
Onset:2021-06-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Headache, Immediate post-injection reaction
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)

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

Write-up: minutes after the vaccine patient states he felt light headed. Stated it had been a while since he had eaten. Given water and crackers. Took a sip and ate 2 crackers. Given ice pack for neck. O2Sat 99%, Pulse 70, RR 20, BP 145/104. State he is suppose to take medication for HTN but has not had them for a while. Continued to feel light headed. Placed in recovery position laying down. After laying him down he states his head was hurting. Talkative and alert. BP 160/120, Pulse 62. Respiratory Rate 16, O2sat 94%. At this time he stated he wanted to go to the hospital. EMS called and he was transported to Hospital.


VAERS ID: 1407987 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-09
Onset:2021-06-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood test, Gait inability, Hypoaesthesia, Magnetic resonance imaging, Pain, Pain in extremity, Paraesthesia, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spirnolactone, mirena
Current Illness: No illnesses
Preexisting Conditions: None
Allergies: Penicillin, latex
Diagnostic Lab Data: Blood test: June 10 Ultrasound: June 12 MRI and blood test: June 14 Physical exam: June 15 Upcoming neurology appt: June 18
CDC Split Type:

Write-up: Paresthesia in right leg, extreme pain from hips down on both sides. Shooting leg pains thought to be sciatica but later ruled out. Pains behind knee. Debilitating pain episodes in right leg. Inability to walk normally due to numbness in right side 2 lateral toes.


VAERS ID: 1407998 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-30
Onset:2021-06-07
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Pallor
SMQs:, Systemic lupus erythematosus (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow), 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? No
Previous Vaccinations:
Other Medications: omeprazole, gabapentin, ibuprofen, betamethasone topical, prednisone, albuterol inhaler, norco generic, carisoprodol
Current Illness: Rheumatoid Arthiritis flares
Preexisting Conditions: Rheumatoid arthritis
Allergies: N/A
Diagnostic Lab Data: Went to the hospital on 6/7
CDC Split Type:

Write-up: Patient reports being at work, starting to look pale, then feeling "like she was having a stroke" on the whole right side of her body. Her joints all became inflamed (possibly related to her rheumatoid arthritis)


VAERS ID: 1408006 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 805020 / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram, Electrocardiogram, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Zoloft; Vit D
Current Illness: no
Preexisting Conditions: no
Allergies: Sulfa medication
Diagnostic Lab Data: ER - EKG and CAT SCAN - to make sure it wasn''t a blood clot - both tests were clear; he couldn''t determine what is was.
CDC Split Type: vsafe

Write-up: Fever and muscle aches for 24 hours; This month, on May 27th, I Had chest pain. Dr had me go to ER - and they did tests - the chest pain went away after about two days.


VAERS ID: 1408021 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN / 1 AR / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Called health system call center to report chills, difficulty breathing, shortness of breathe and throat hurts when she speaks. She took a tab of 500mg tylenol yesterday after the vaccine and one about 2hours ago.


VAERS ID: 1408028 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-17
Onset:2021-06-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Feeling cold, Flushing, Hyperhidrosis, Oropharyngeal discomfort, Rash, Tunnel vision
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Optic nerve disorders (broad), Retinal disorders (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Client received the Janssen COVID vaccine lot #205A21A and expiration date 6/23/21 at approximately 3:01PM. Client arrives to the vaccine observation room and within 10 minutes reports feeling lightheaded and having tunnel vision to EMTs. EMT takes vitals: blood pressure 170/92, heart rate 80 and oxygen sat: 94%. PHNs arrive to assess client. Client is upright in chair alert and oriented x 4. Client denies any shortness of breath. PHNs observe sweating and rashes on left and right arms. Client reports his oxygen is normal for him since he has COPD. Client reports having a history of severe anaphylaxis allergy to penicillin, client reports taking morphine, lexapro, tizanidine, lyrica, and remeron. At 1:15pm client reports feeling "clammy and cold". Clients face is flushed and rash is spreading to neck, upper chest, lower left leg. PHN offers client Benadryl and he accepts. PHN starts calling 911 at 1315. PHN administered 50 mg of IM Benadryl at 1:17pm. At 1:17pm, vitals by EMT: heart rate:88 and oxygen: 94%. Client reports he "feels something in his throat" at 1:18PM. At 1:20pm client reports feeling in his throat is improving. At 1:20pm paramedics arrive and assume care. Client left facility wheeled out on a gurney at 1:27pm. Client will get transported to hospital. PHN alert security that a car left here overnight might belong to client being transported.


VAERS ID: 1408213 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-04
Onset:2021-03-24
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Verapamil 180mg, Sertraline 100mg, Clonazepam .5mg, Warfin 5mg, Omeprazole 20mg, Vitamin D 125mcg, Multivitamin
Current Illness: None.
Preexisting Conditions: Fractured vertebrae since 2001, fractured pelvis Sept 2018.
Allergies: Penicillin, Contrast dye, Iodine
Diagnostic Lab Data: Several!
CDC Split Type:

Write-up: Shortness of breath. Have been on 24 HR oxygen since! (2-3 liters/hr)


VAERS ID: 1408240 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-26
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Dyspnoea, Epistaxis, Fatigue, Thrombosis
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Duloxetine 30mg once daily, Quetiapine 300mg once nightly, Folic Acid 1mg once daily, Thiamine 100mg once daily, Divalproex DR 500mg twice daily
Current Illness: Unknown
Preexisting Conditions: Patient stated he had COVID infection in March
Allergies: NKDA
Diagnostic Lab Data: Unknown. Patient was in hospital.
CDC Split Type:

Write-up: patient stated he went to the hospital for blood clots. Says he went in last Tuesday or Wednesday for heavy breathing. Normal activity was making him very tired. Had COVID infection in March. The doctors cannot determine what other cause could have led to him having blood clots. Patient was released yesterday from being in since last Tuesday or Wednesday. Patient says he''s having nose bleeds starting today. He was on the blood thinner shots but not sure of the name. Now he is on the pills (Eliquis) from pharmacy instead of the shot.


VAERS ID: 1408248 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-16
Onset:2021-03-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood test, Burning sensation, Electrocardiogram, Headache, Hypoaesthesia, Inflammation, Magnetic resonance imaging, Magnetic resonance imaging head, Musculoskeletal stiffness, Pain
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pycnogenol, Multivitamin
Current Illness: Chronic Lyme
Preexisting Conditions: CVI
Allergies: Codeine, Minocycline
Diagnostic Lab Data: Multiple healthcare visits, including MDs, chiropractor, massage, EKGs. Bloodwork and 4 MRIs of brain and neck.
CDC Split Type:

Write-up: Woke up early next morning with a blinding headache, stiff and inflamed neck, and pain, burning, numbness and tingling in both arms down to my fingertips.


VAERS ID: 1408651 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-09
Onset:2021-06-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Hypertension, Tremor
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient awoke at 2:30 am after getting vaccine with uncontrollable shaking. Went to ER and blood pressure was also high. Given Ativan to decrease shaking and calm patient. Diagnosed with allergic reaction to vaccine by ER staff.


VAERS ID: 1409471 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Gait inability, Hypertension, Illness, Malaise, Nausea, Unevaluable event, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Arthritis; Diabetes; Neuropathy; Non-smoker; Thyroid disorder; Walker user
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: 200 over something
CDC Split Type: USJNJFOC20210627061

Write-up: HIGH BLOOD PRESSURE; COULDN''T WALK; COULDN''T DO ANYTHING; SO SICK; NOT FEELING WELL; VERTIGO; VOMITING; NAUSEA; This spontaneous report received from a patient concerned a 96 year old female. The patient''s weight was 128 pounds, and height was not reported. The patient''s concurrent conditions included arthritis, neuropathy, thyroid issue, non smoker, non alcohol user, diabetes, and cannot walk without a walker, and other pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022 expiry: 25-MAY-2021) dose was not reported, administered on 30-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced vomiting. On MAR-2021, the subject experienced nausea. On 31-MAR-2021, the subject experienced vertigo. On an unspecified date, the subject experienced high blood pressure, couldn''t walk, couldn''t do anything, so sick, and not feeling well. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) 200 over something. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from vertigo, high blood pressure, not feeling well, couldn''t walk, couldn''t do anything, and so sick, and the outcome of nausea and vomiting was not reported. This report was non-serious.


VAERS ID: 1409888 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Nevada  
Vaccinated:0000-00-00
Onset:2021-03-26
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Fatigue, Hypoaesthesia, Malaise, Muscle contracture
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Environmental allergy; Numbness; Sciatica
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210633336

Write-up: FATIGUE; LEFT HAND CLENCHED INTO FIST FOR THE PAST TWO MONTHS AND A HALF; PREVIOUS RIGHT SIDED NUMBNESS WAS MORE INTENSE; DECREASED ENERGY; FEELING UNWELL; This spontaneous report received from a patient concerned a 63 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included sciatica, numbness of the right side, and environmental allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 26-MAR-2021, the subject experienced left hand clenched into fist for the past two months and a half. On 26-MAR-2021, the subject experienced previous right sided numbness was more intense. On 26-MAR-2021, the subject experienced decreased energy. On 26-MAR-2021, the subject experienced feeling unwell. On an unspecified date, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from left hand clenched into fist for the past two months and a half on 15-MAY-2021, had not recovered from decreased energy, feeling unwell, and previous right sided numbness was more intense, and the outcome of fatigue was not reported. This report was non-serious.


VAERS ID: 1409968 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-16
Onset:2021-06-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Anxiety, Dizziness, Feeling abnormal, Nausea, Presyncope, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (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? 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: She states she did not eat breakfast but this is normal for her and had coffee this morning, nothing else out of the ordinary. Was very anxious feeling before the vaccine. Pt to ER for dizziness after she received covid vaccine About 5 minutes afterwards she began feeling more anxious, as well as dizzy and lightheaded, vomiting once. No LOC noted. At this point feeling a little "foggy" which has persisted. She has been ambulatory and has no focal weakness or other problems. No history of reactions to other vaccines in the past. Lightheadedness Vasovagal episode . Nausea,Vomiting. ED visit,Monitoring at vaccine site


VAERS ID: 1410002 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805002 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Agitation, Anxiety, Chest discomfort, Cold sweat, Feeling abnormal, Feeling jittery, Full blood count normal, Hypoaesthesia, Nervousness, Paraesthesia, Peripheral swelling, Throat tightness, Tremor, Urine analysis normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu-Yr unknown
Other Medications: Gardiance, Ganuvia, Lipitor, Fish Oil, Vit D., Zinc, Singular
Current Illness: no
Preexisting Conditions: Diabetes, Asthma
Allergies: Penicillin, Streptomyocin, Aspirin products, nuts and fruits with red pigment
Diagnostic Lab Data: CBC-normal Urinalysis-normal
CDC Split Type: vsafe

Write-up: The next day after my left arm got really swole and it begin to tingle. I reached out to my PCP who advised I see a Specialist and gave an Anti-inflammatory but it did nothing. A couple week later around 2:30am I woke up out of my sleep with severe shakes in my chest area, my arms and hands go so clammy and I felt so anxious I couldnt sit still and was pasing back and forward. I had the sense of feeling choked. The shakes were so bad causing me to get up and walk around. At 4am I went for a walk in the neighborhood because I still could not stop shaking and remain still. I was so adjitated around 6am I got up and began to drive to the beach then all of the sudden after about 20 minutes I had to pull over because my arms from elbow down went numb and I couldn''t drive. I was still so jittery and shaky but was able to make it to the ER where I was monitor for about 5 hrs. CBC and Urinalysis were done but everything seemed normal. For about 10 days I had that shaky feeling, tightness in my chest area and just felt really crappy. My PCP perscribed a few different Anti-anxiety meds but I had an allergic reaction to those so I could not take any of those either. I have an appointment with the Neurologist 7/26.


VAERS ID: 1410043 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Laboratory test, Muscle tightness, Stiff leg syndrome
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Vestibular disorders (broad), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Patient felt faint and dizzy, Her right hand started tightening up and she could not move it and it hurt. EMS was called arrived within a few mins. Her legs were becoming stiff. She was immediately taken to the hospital by EMS for possible blood clot.


VAERS ID: 1410102 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-07
Onset:2021-06-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Electrocardiogram, Full blood count, Head discomfort, Metabolic function test, Palpitations, Syncope, Urine analysis, Venogram, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (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: Multivitamin Vitamin D3
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: 6/12/2021: ER work up- CBC, CMP, EKG, CT head and CT head venogram 6/15/2021: ER work up - CBC, CMP, urinalysis, EKG, orthostatics
CDC Split Type:

Write-up: Head pressure, vertigo, syncope, palpitations


VAERS ID: 1410106 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-03
Onset:2021-06-07
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: had stroke dont know if vaccine was cause of problem


VAERS ID: 1410265 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type: Unknown

Write-up: Patient was given the vaccine at 10:08 AM and was told to remain in close proximity to the pharmacy incase of an event. Shortly after the patient was slumped over to the right and slightly forward. Pharmacist on duty instructed near by associates to get cold water and candy bar as the patient said he had not eaten before coming to the vaccine appointment. 911 was called and paramedics arrived at the store to provide further care for the patient. No other information is known at this time.


VAERS ID: 1410318 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-13
Onset:2021-05-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein normal, Chest pain, Echocardiogram, Electrocardiogram abnormal, Pericarditis, Red blood cell sedimentation rate normal, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Previously healthy 22 yr old male with 6 days of chest pain, nl toponin, ECHO, CRP and ESR and mild abnormal ECG, patient given clinical diagnosis of pericarditis which seems correct.


VAERS ID: 1410351 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-30
Onset:2021-06-18
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain
SMQs:, Retroperitoneal fibrosis (broad)

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

Write-up: Patient called our office, chief complaint backpain


VAERS ID: 1410359 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-05-24
Onset:2021-06-11
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Bell's palsy, Blood test, Computerised tomogram, Facial nerve disorder, Intensive care, Magnetic resonance imaging head, Neurological symptom, SARS-CoV-2 test, Varicella virus test negative, Viral test negative
SMQs:, Hearing impairment (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81mg , hydroChlolothiazide 25mg , Lisinopril 20mg , Rosuvastatin 20mg
Current Illness: No
Preexisting Conditions: high blood pressure ?
Allergies: Agave, Sunflower in any form (oils, seeds, flour) Walnuts Pine Ragweed
Diagnostic Lab Data: MRI (2) CAT Scan Multiple Blood work Covid- 19 Test You can contact my physician they know the test better than I
CDC Split Type:

Write-up: 1pm on 06/11/2021 I experienced stroke symptoms. was rushed by ambulance to Hospital. CAT scan, MRI were done and TPA was given. No large blood clots were found but meds were used as precaution for smaller clots. Was transferred to Hospital to Neurological Stroke Unit ICU was there for 4 days. I was tested for various viruses and shingles they were negative including the Covid test. They found a problem with 7th nerve bundle . Bell"s Palsy was diagnosed . They are researching how and why this occurred. I am home resting and recuperating.


VAERS ID: 1410363 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-29
Onset:2021-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 7808978 / 1 - / SYR

Administered by: Military       Purchased by: ?
Symptoms: Aphasia, Blood test, Computerised tomogram, Impaired work ability, Pneumonia, Urine analysis, X-ray
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram
Current Illness: Elhers Danlos
Preexisting Conditions: Elhers Danlos
Allergies:
Diagnostic Lab Data: Ct scans, blood work, urine,, and x-rays
CDC Split Type:

Write-up: Developed pneumonia and is still having on-going problems which I''m being treated for now. Haven''t been able to work since 04/19/2021


VAERS ID: 1410375 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Blood pressure increased, Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UTO
Current Illness: UTO
Preexisting Conditions: UTO
Allergies: NKDA
Diagnostic Lab Data: Pt referred to, transport to Hospital. ADI Run Number: 21-030038
CDC Split Type:

Write-up: Pt became severely dizzy and anxious after vaccination. mild HTN.


VAERS ID: 1410388 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-07
Onset:2021-06-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Antibody test negative, Blood fibrinogen increased, Differential white blood cell count, Fibrin D dimer, Full blood count normal, Glomerular filtration rate increased, Lymphocyte count, Metabolic function test normal, Neutrophil percentage, Petechiae, Prothrombin time
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Selegiline 5mg - two tablets PO q AM four days a week, one tablet PO q AM three days a week (started July 2006) Alprazolam XR 0.5mg - two tablets PO q AM, on tablet PO q HS (started July 2006) Levothyroxine 25 mcg - one tablet PO q AM (st
Current Illness: None
Preexisting Conditions: Treatment Resistant Major Depression - in remission 15 years Generalized Anxiety D/O - in remission 15 years Hypothyroidism - diagnosed 12-2020 Bradycardia - mild - no treatment needed.
Allergies: Polyethylene Glycol Cashews Almonds Z Pac (Azithromycin) Medication reactions to Selegiline - Demerol, NSAIDs, Bactrim, Metronidazole
Diagnostic Lab Data: 6/11/21: CBC with Platelet and Differential - all except slightly increased Neutrophils at 69.9 and slightly decreased lymphocytes at 22.0 Basic Metabolic Panel D-Dimer x 2 - 0.27 Estimated GFR - 85 Heparin PF4 Antibody (IGG) - Negative @ 0.115 - so Normal Fibrinogen - High at 505, but not considered high enough to be at risk for a blood clot. Partial Thromboplastin Time (PTT) - 26.2 - 6-15-21 - repeat labs with PCP - PTT, Activated - 28 - WNL Prothrombin Time (PT) - 1.0 - WNL D-Dimer - 0.27 - WNL Basic Metabolic Panel - WNL CBC with Platelets and Differential - WNL Fibrinogen - Pending Estimated GFR - Pending PF4 Antibody - Pending
CDC Split Type:

Write-up: Petechiae, mild but present - first noticed on upper R arm opposite injection on 6/10/21. By next morning, 6/11/21 mild petechiae noticed down both forearms. Since vaccination information recommended seeking immediate attention, I went to Hospital ER. Dr. was the physician who saw me. Labs were completed and all returned within normal limits. I was discharged and advised to follow up for repeat labs with my PCP on 6/15/21. On 6/15/21 I met with my PCP, Dr., who repeated the same labs that were done at Hospital. Not all results are back, but so far the results that have returned are still within normal limits and relevant values do not appear to be decreasing significantly. I called Jahnssen, and they were unable to advise if I should get labs repeated again in the coming weeks to ensure I am not having an issue with Vaccine-induced Thrombocytopenia. My PCP and the ER physician do not know what to advise either given the newness of these side effects. I have noted Petechia (mild) on my torso and thighs, so seems to be progressing down my body or becoming more noticeable.


VAERS ID: 1410414 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-15
Onset:2021-03-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Chest X-ray, Colitis, Computerised tomogram abnormal, Death, Dyspnoea, Malaise, SARS-CoV-2 test negative, Vision blurred, X-ray
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-30
   Days after onset: 39
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: Flu unknown date many years ago
Other Medications: Eliquis, Calcium, Atorvastatin, Cyanocobalamin, Divalproex, Donepezil, Escitalopram, Fluconazole, Levothyroxine, Pantoprazole, Fish Oil, Tylenol
Current Illness: Dementia, Parkinson''s, Alzheimers, Afib, Hypothyroidism, Bilateral Brain Aneurisms,
Preexisting Conditions: Same as above
Allergies: Sulfa
Diagnostic Lab Data: 4/12 blood work at doctor. 4/13 blood work, cat scan and chest x-ray at Hospital. 4/14 blood work ran at Hospital, 4/15 Blood work at Hospital. Extra labs and cat-scans, x-rays while admitted.
CDC Split Type:

Write-up: Janssen Covid-19 EUA 3/22 started feeling ill. 4/4 went for nasal swab Covid test 4/9 results negative. 4/12 went to doctor with extreme abdominal pain, shortness of breath, blurred vision. Ran bloodwork. Sent to ER for cat-scan. Results were colitis. Back to ER x3. Finally admitted and put on antibiotics, and fluids. Released home to hospice after 4 days. Died on 4/30 with cause of death, colitis.


VAERS ID: 1410417 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-28
Onset:2021-05-02
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: School       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Chest X-ray, Dizziness, Electrocardiogram, Fibrin D dimer, Full blood count, Heart rate irregular, Metabolic function test, Troponin
SMQs:, Anticholinergic syndrome (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None at that time of vaccination
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC CHEM 12 TROP D-DIMER, TSH EKG CXR on both may 17 and jun 18 of 2021
CDC Split Type:

Write-up: Dizziness irregular heart rate


VAERS ID: 1410879 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Patient started to not feel well about 2 minutes after injection, asked for water. I grabbed co-worker (my pharmacist as I am a student) and she stayed with him while I called 911. He passed out on here, came back to, EMTs arrived and he again passed out on them so they took him to ambulance on stretcher


VAERS ID: 1411000 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Fatigue, Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: VARIOUS VACCINES/AGES
Other Medications: none per wife
Current Illness: none per wife
Preexisting Conditions: hx of syncope with vaccination/needles
Allergies: an unknown pain medication, wheat, gluten, milk
Diagnostic Lab Data: BP 117/68, O2 LEVEL AT 99% 10 MINUTES POST VACCINE
CDC Split Type:

Write-up: PT EXPIERENCED SYNCOPE ABOUT 3 MINUTES POST VACCINATION. HAD A SECOND SYNCOPE EPISODE 5-6 MINUTES POST VACCINATION. PT WAS TRANSPORTED TO LOCAL HOSPITAL BY EMS. PT REPORTED EXTREME FATIGUE, NAUSEA AND VOMITING. ABOUT 5 HOURS POST VACCINATION, PTS WIFE REPORTS PATIENT IS FEELING MUCH BETTER.


VAERS ID: 1411038 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-07
Onset:2021-06-01
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cerebral haemorrhage, Cerebral venous sinus thrombosis, Headache, Intensive care, Migraine, Nausea, Pain, Unresponsive to stimuli, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vienva, Levonorgestrel and Ethinyl Estradiol Tablets, USP 0.01 mg, 0.02 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: There were many tests run during her stay at the hospital 6/3 - 6/11/21
CDC Split Type:

Write-up: 6/1 She woke up with a severe headache and vomiting. She went to the urgent care and was treated for migraine headache and nausea. She was giving medication for pain and vomiting. Slept until the next day. Felt somewhat better the next day and continued meds. She went to work on 6/3 and towards the end of her shift she told her boss about the severe headache and sat in her car outside and then became unresponsive. The paramedics were called and she was transferred to the hospital and diagnosed with a brain blood clot and brain bleeding. She was flow by air car to another hospital and admitted to ICU. She was in Neurology ICU until 6/6, and then transferred to a normal neurology bed and released on 6/11. Diagnosis of left venous sinus thrombosis and hemorrhage in the left temporal lobe.


VAERS ID: 1411089 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-06
Onset:2021-06-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Fatigue, Feeling abnormal, Headache, Injection site pain, Myalgia, Oropharyngeal pain, Rash papular, Rash pruritic, Skin burning sensation, Sleep disorder, Tremor, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Baclofen Tylenol#4 Ultram er protonix inderal la zofran sumatriptan
Current Illness: CVA vs complex migraine, anemia,
Preexisting Conditions: Complex migraine, si joint fusion, steroid injection epidural, anemia, ptsd, Gerd
Allergies: Mushrooms
Diagnostic Lab Data: No doctor visit yet will go to ER soon if symptoms worsen
CDC Split Type:

Write-up: Severe raised burning itching rash, severe headache, vision blurred, very tired fatigue, joint muscle pain, throat pain, mental fog slowness,severe pain at surgery site, increased tremor, pain in chest, itching keeps waking me up


VAERS ID: 1411096 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyskinesia, Immediate post-injection reaction, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Assumed Vaso-Vagal Syncope, patient was nervous about receiving an injection. Immediately after removal of the syringe, the patient leaned backwards. He stated that he felt dizzy. He started to jerk his head backwards (911 called) and then his head fell forward, unresponsive. At his time, we used an ammonia inhalant close to the nose. He started to move and we brought him to the floor supine with a pillow at his feet and then his head. Soon, he was able to sit up and we brought him water to drink. He was subsequently cleared by the EMT to go home.


VAERS ID: 1411543 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-08
Onset:2021-05-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests, Ear discomfort, Foreign body in ear, Immunodeficiency
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Hearing test on June 1, 2021 and June 15, 2021.
CDC Split Type:

Write-up: At approximately noon on May 9, 2021, I observed that I was having some difficulty with hearing in my right ear consisting of a "blocked" feeling with some distortion ? I have had occasional issues of this nature previously which have normally been rectified by "over the counter" products.On the afternoon of May 12, 2021, there had been no improvement, so I sought assistance at the facility located in town. Personnel there initially attempted to "flush" my ear without any improvement. I was then seen by a Dr. who was on duty at the facility ? Dr. indicated that there appeared to be some sort of plastic "tube" in my ear. Dr. indicated that this was best handled by a specialist in the field, and provided me with the information on a local practice. I was seen on May 18, 2021 at the offices of facility located near a Dr. I explained to Dr. what Dr. had seen ? he located the item and removed it from my ear. This item has not, as yet, been identified ? Dr. initially speculated that it may be part of a hearing aid, which I have NEVER had. I subsequently saw Dr. again on June 1, 2021, as the issues were persisting. At that time, a "Hearing test" was administered by a ophthalmologist. Dr. prescribed a course of 50 Prednisone (10 MG tablets) to be taken as follows at breakfast time: Six tablets for the first six days Four tablets for the next two days Two tablets for the next two days One tablet for the next two days Dr. reasoning at that time was that he believed that the vaccine may have provoked some sort of "immune deficiency". He advised that I should see him again in two weeks for a further hearing test/consultation. I completed the course of Prednisone on June 13, 2021. I underwent a further hearing test with ophthalmologist on the morning of June 15, 2021 as agreed ? prior to the test, I indicated to ophthalmologist that I expected the results to be, to all intents and purposes, identical to the previous one: this proved to be the case. I subsequently indicated to Dr. that the Prednisone had been, from my perspective, totally ineffective. He is, at the time of writing, unable to offer any explanation for the issue or "path forward" from it: I am presently seeking a second opinion.


VAERS ID: 1412219 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Alabama  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 031541502 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Fluid overload, Malaise, Oxygen saturation, SARS-CoV-2 test positive, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ADEMPAS; OPSUMIT; AMLODIPINE
Current Illness: Primary pulmonary hypertension
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Oxygen saturation; Result Unstructured Data: Decreased; Test Name: COVID-19 virus test positive; Result Unstructured Data: Not reported
CDC Split Type: USJNJFOC20210624724

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; COVID-19 INFECTION; FLUID OVERLOAD; NOT FELT WELL; This spontaneous report received from a health care professional concerned a 57 year old adult male, ethnicity not reported. The patient''s weight was 110.9 kilograms, and height was not reported. The patient''s concurrent conditions included primary pulmonary hypertension. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, frequency 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. The patient received Uptravi (selexipag) (tablet, oral, batch number: 031541502 expiry: 31-JUL-2022) 1000 ug, 2 times every 1 day, therapy dates were not reported for primary pulmonary hypertension. Concomitant medications included amlodipine, Opsumit (macitentan), and Adempas (riociguat). On an unspecified date, patient received covid-19 vaccine and had not felt well since then. He was diagnosed with covid-19 infection and was advised by primary care physician to go to the emergency room for worsening shortness of breath and decreased oxygen levels. The patient went to emergency room and fluid overload has also been determined. The patient had suspected clinical vaccination failure. Laboratory data (dates unspecified) included: COVID-19 virus test positive (NR: not provided) Not reported, and Oxygen saturation (NR: not provided) Decreased. The action taken with covid-19 vaccine ad26.cov2.s was not applicable; and dose of selexipag was not changed. The patient had not recovered from covid-19 infection, not felt well, and fluid overload, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint number 90000182758. Additional information received from Product Quality Vigilance on 14-JUN-2021. .; Sender''s Comments: V0 20210624724-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS. V0 20210624724-UPTRAVI-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1412238 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-04-05
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Deep vein thrombosis, Magnetic resonance imaging, Pain in extremity, Pulmonary embolism, X-ray
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AMLODIPINE; OMEPRAZOLE; ATORVASTATIN; CETIRIZINE; LEVOTHYROXINE; FLUTICASONE
Current Illness: Alcohol use (6 pack over span of 2 weeks, not a heavy drinker, denies recent alcohol intake since starting new medication.); Blood pressure high; Food allergy; Iodine allergy; Non-smoker; Seasonal allergy
Preexisting Conditions: Comments: Patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: MRI; Result Unstructured Data: Pulmonary embolism; Test Date: 20210419; Test Name: X-ray; Result Unstructured Data: Pulmonary embolism
CDC Split Type: USJNJFOC20210629366

Write-up: RIGHT LEG DEEP VEIN THROMBOSIS; RIGHT ARM PAIN; PULMONARY EMBOLISM; This spontaneous report received from a patient concerned a 70 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included high blood pressure, alcohol user, non smoker, tree allergy, onion allergy, topical iodine cleanser allergy, and weeds allergy, and 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: 1802070 and expiry: UNKNOWN) dose was not reported, 1 total administered on 19-MAR-2021 on left arm for prophylactic vaccination. Concomitant medications included amlodipine, atorvastatin, cetirizine, fluticasone, levothyroxine and omeprazole used for unknown indication. On 05-APR-2021, the patient experienced chest pain, shortness of breath, extreme shortness on upper back, right arm pain, right rib cage pain. On 19-APR-2011 patient was travelling, took a bus, when patient arrived, symptoms were so severe that patient could not pick up the luggage. Patient arrived around 5:30pm to his destination and was taken to the ER (emergency room). Patient had x-rays and an MRI done, and was admitted to hospital. Patient was discharged on 24-APR-2021 (hospitalized for 5 days) with diagnosis of acute pulmonary embolism, Shortness of breath, right leg deep vein thrombosis, pain in chest, elevated troponins. Patient was prescribed Eliquis during this admission and patient was currently taking it. On 11-JUN-2021 Patient went to the hospital out of town and was admitted. Patient had chest pain and right arm pain, and right side rib pain. Patient was discharged on 12-JUN-2021 and diagnosed with pulmonary embolism. Patient stated that the chest has improved since starting to take Eliquis, but still feels pressure on the right side of rib cage and felt has not fully recovered yet. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from right arm pain, and had not recovered from pulmonary embolism, and right leg deep vein thrombosis. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210629366-COVID-19 VACCINE AD26.COV2.S- Pulmonary embolism, right leg deep vein thrombosis, right arm pain. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event. 20210629366-COVID-19 VACCINE AD26.COV2.S- right arm pain. This event is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1412253 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Oregon  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Suspected COVID-19, Vaccination failure, Vomiting
SMQs:, Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immune disorder (NOS); Multiple disabilities
Preexisting Conditions: Medical History/Concurrent Conditions: Flu
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210632001

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; VOMITING; This spontaneous report received from a health care professional concerned a female of unspecified age, ethnic origin and race. The patient''s height, and weight were not reported. The patient''s past medical history included flu virus, and concurrent conditions included disabilities and compromised immune system. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total, administered on an unspecified date in APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient experienced suspected covid-19 infection, suspected clinical vaccination failure, vomiting and not being able to hold down water or food. ER (Emergency Room) balanced her system, just like they had to when her ?crones like symptoms'' had caused many times, for many years, without any viral infection. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection, suspected clinical vaccination failure and not being able to hold down water or food was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210632001-Covid-19 vaccine ad26.cov2.-Suspected Clinical Vaccination Failure . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1412665 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-17
Onset:2021-06-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Nausea, Tremor
SMQs:, Anaphylactic reaction (broad), 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), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Medium


VAERS ID: 1412675 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Hypoaesthesia, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Vomiting-Medium


VAERS ID: 1412834 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-26
Onset:2021-05-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Blood thyroid stimulating hormone, Brain natriuretic peptide, Fibrin D dimer increased, Full blood count, Haemoglobin, Laboratory test, Low density lipoprotein, Muscular weakness, Ultrasound Doppler
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Tenormin Lipitor Metformin Amlodipine
Current Illness:
Preexisting Conditions: Hypertension DM II Obesity High cholesterol
Allergies: Penicillin Aspirin
Diagnostic Lab Data: CBC, BNP, CHEMISTRY PANEL, hemoglobin a1c, ldl, tsh, d-dimer, creatine kinase Lower extremity venous us Doppler all done in 6/14/21
CDC Split Type:

Write-up: Weak legs from 5/30 until 6/14 6/14 labs done show D-Dimer elevated 6/14 venous lower extremity Doppler US showed right distal femoral vein non occlusive thrombus


VAERS ID: 1412865 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Consciousness fluctuating, Eye movement disorder, Hyperhidrosis, Hypotension, Mydriasis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Paramedics checked her blood pressure and it was low. 99/66 mmhg.
CDC Split Type:

Write-up: The patient fainted upon exiting the vaccine room and sitting back in her observation chair approximately two minutes after the vaccine was given. She was in and out of consciousness for about 10 minutes total, was sweating heavily, and eyes dilated and unable to track. We applied a cold compress and ice packs, and then laid patient down flat. Upon laying her down she quickly came back to consciousness and then the paramedics arrived. Paramedics recommended patient go to the hospital for fluids, but patient felt like she was okay. She went out to the ambulance for further observation and testing.


VAERS ID: 1412929 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Computerised tomogram, Feeling abnormal, Headache, Hypertension, Muscle twitching, Nervousness, Pain in extremity, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Hypertension (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot, got the flu (25 years ago or so), don''t get them anymore
Other Medications: Atenolol; lisinopril
Current Illness: No
Preexisting Conditions: Just high blood pressure
Allergies: No
Diagnostic Lab Data: CAT scan without the dye (to make sure I wasn''t having a stroke) something in my brain, white brain matter; blood tests. Slightly elevated white blood count and just a bit below normal on the red cell count and neutrophil absolute was high; X-Ray of chest single view, normal.
CDC Split Type: vsafe

Write-up: Arm pain the first week. Then on the eighth day, I had twitching (whole body) like I was having a seizure but it wasn''t. It only happens when I lay down. Then I had a headache, maybe a little that first week after, but when the twitching the headache got worse. When the twitching was severe it was every couple of minutes. The headache could be associated with other problems. I wasn''t sleeping. The headache gets worse at night time. If I lay on the left side where the headache is on it gets way worse. Then my hip hurts if I lay on other side because I had hip replacement. My blood pressure got so high, went up to 212/110. I went by ambulance to ER. At one point, 240 over 110 (the ambulance guy told me it got up that high). But then at hospital it was back down to 212/110. I had been taking my blood pressure was not going down and that''s why I called. I got to the hospital and they took all types of tests and blood and x-ray of my chest. Then they gave me one shot in the IV of Ativan. That helped a lot. It stopped the twitching for 24 hours. But now the twitching is back but it''s less often. The next day after the hospital I slept all day and didn''t twitch. Just last night I couldn''t sleep at all. Not just the twitching but I was just restless. I have a headache today, too, and have been in bed all day. I''m trying to stay calm because I don''t want the blood pressure to go up. No new meds after the hospital. I still feel pretty bad and will see my doctor on Monday follow up. I''m nervous to take blood pressure reading, trying not to take it.


VAERS ID: 1412938 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-08
Onset:2021-06-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram, Laboratory test, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: chest pain, chest pressure and shortness of breath


VAERS ID: 1412969 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-19
Onset:2021-06-18
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: none but recently diagnosed with breast cancer 4/15/2021
Allergies: none
Diagnostic Lab Data: CT scan and bloodwork 06/18/2021
CDC Split Type:

Write-up: Bell''s Palsey


VAERS ID: 1412973 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-01
Onset:2021-05-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, COVID-19, Carotid artery thrombosis, Cerebrovascular accident, Computerised tomogram, Cough, Dizziness, Electrocardiogram, Fall, Headache, Intensive care, Magnetic resonance imaging, Malaise, Pneumonia, SARS-CoV-2 test positive, Thrombolysis, Thrombosis, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Thrombophlebitis (broad), Accidents and injuries (narrow), Hypertension (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No meds
Current Illness: None
Preexisting Conditions: COPD
Allergies: None
Diagnostic Lab Data: Dr has not provided all the tests that were ran. Ekg, mri, ct scan, X-rays
CDC Split Type:

Write-up: On May 20th he came down with a cough and not feeling well. Went to hospital on May 22 and was diagnosed with pneumonia. Gave iv antibiotics and fluids. Sent home. On may 24 went back because he was worse. Temperature and high blood pressure and a headache. They admitted him to the hospital then checked him for covid. He was positive. They gave him a shot on may 24 and May 25th in the stomach for blood clots. On may 25th they sent him home. He started feeling better may 28. Then on June 17th he fell out of his chair complaining of severe dizziness. Called 911 and they transported him to hospital. Did a procedure to see if there were any blood clots. It was determined that he had a blood clot in his artery in the neck. They gave him tPA to break up the clot right away. Then transported him to the hospital to the icu. It was determined that the blood clot caused the stroke. Still having severe dizziness. Released him to rehab on 6/18 @ 4:30 pm


VAERS ID: 1412979 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dermal filler injection, Lip swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling of lips and face, no airway compromise. IM Epinephrine, swelling decreased. Pt stated similar reaction to flu shot. Patient did not disclose previous allergic reaction in vaccine questionnaire or verbally. Pt stated lip and botox injection sites were areas of swelling.


VAERS ID: 1413023 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-11
Onset:2021-03-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Myalgia, Pain in extremity, Peripheral swelling, Urine analysis normal, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Naproxen; Cyclosporine; Multi-Vitamins
Current Illness: No
Preexisting Conditions: Auto-immune diseases - Psoriatic arthritis; Pascual Psoriasis: Hemlock Charlene Purpura
Allergies: Penicillin and Codeine; Shellfish
Diagnostic Lab Data: 4/19/2021 - ER all normal results; X-rays; Bloodwork and urine; ER for the second time; 5/6/2021; X-rays 5/14/2021 everything was okay on my joints found a nodule on the left lung; CAT SCAN my Rheumatoid doctor sent me for this a week after the x-rays of 5/14/2021 had it done on a Saturday 5/21/2021 to see the size of the nodule. 5/21/2021 all kinds of bloodwork. Have an appt with Pulmonologist to see if I need a biopsy on my lung 30th of this month.
CDC Split Type: vsafe

Write-up: Pains in my legs severe joint pain in knees, ankles, and muscles. I ended up going to doctor first. The primary care doctor about a week after the vaccine on a Thursday he gave me Prednisone to try to get the swelling down. It kind of worked for a time. As soon as the Prednisone stopped, I couldn''t walk. I was at work and they sent me home from work. I ended up in the ER and that was on 4/19/2021. They gave me shot of pain killer and a couple of prednisone again. That helped me to walk for a few days. Then I ended up back in the hospital on 5/6/2021 for the same thing. They did bloodwork and x-rays again and gave me pain killers. No prednisone at that time. Then I got in touch with a Rheumatoid Doctor, and she ordered tons of bloodwork on 5/21/2021. All of that was normal as well. If I try to walk at work, I have to go home within three days because of the pain and legs swell up so badly. I work as a teacher''s aide. I have fallen a couple of times when the legs swell up. My doctor doesn''t know what kind of treatment to give me until when I see the Pulmonologist except for pain killers Tramadol 50mg as needed. Try to just take one or two a day if that. I try not to take anything but I''m at the point where I can''t sleep at night because of the pain ice it at night even just to stop the pain. Can''t walk my dog and help take care of my mother. I would use to hit 12,000 steps by noon at work. Meth prednisone 5 pills a day at 4mgs to keep swelling just at a minimum. Still, if I try to go food shopping by 03:00 pm I am in excruciating pain for being on my legs too much. If I do laundry, I''m okay for a bit but then it''s just exhaustion for the day and then I''m done for the day and that''s just not me. I''ve lived with these autoimmune diseases my entire life and I''ve never had my joints swell up like they have or have been in this much pain ever.


VAERS ID: 1413032 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose normal, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: denies
Current Illness: denies
Preexisting Conditions: denies
Allergies: denies
Diagnostic Lab Data: Glucose
CDC Split Type:

Write-up: 1325 Pt lost consciousness and feel to the floor from a sitting position. Per reports, pt hit his head on the floor. EMS team activated. POD Director at pt side along with NP. 1326 911 called and emergency services activated 1327 Pt is not A/O x4 and answering all questions appropriately. 1340 Fire dept arrived. Pt sat up and being transferred to fire care 1341 Patient placed in a sitting position, A/Ox4 and swering all questions appropriately Vitals 1326 HR 50, RR 16, Sat 93% 1328 HR 85, RR 16, Sat 98%, BP 139/83 laying position 1331 Glucose 90 1338 HR 89, RR 16, Sat 99%, 1341 HR 69, RR 16, Sat 98%, BP 140/87 Sitting position 1343 BP 136/83


VAERS ID: 1413041 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-18
Onset:2021-06-12
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Dehydration, Diarrhoea, Feeling abnormal, Fluid replacement, Nausea, Renal pain, Urine analysis normal
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol; Analtrol; Centrum Vitamin
Current Illness: no
Preexisting Conditions: Diabetes Type 2
Allergies: none
Diagnostic Lab Data: Urine test and blood work everything was good 6/11/2021 at doctor''s.
CDC Split Type: vsafe

Write-up: Stomach pain, extreme diarrhea, nausea. Got so dehydrated they put me an IV fluid at doctor''s urgent care walk-in on 6/11/2021. My kidneys were hurting. Ciprofloxacin 500 mg 10 days, 1 tablet by mouth twice a day. Could have been a stomach virus. I still don''t feel back to 100%. I still feel a little queasy every now and then. She wanted a stool sample, but I was too dehydrated for that.


VAERS ID: 1413052 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / 1 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Patient was referred to the Urgent Care. No lab tests at this time.
CDC Split Type:

Write-up: Patient has had a tactile fever, nausea, myalgia, chest pain and severe headache.


VAERS ID: 1413083 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-26
Onset:2021-06-18
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816027 / N/A - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Embolism, Pulmonary embolism
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: AMOXICILLIN, PENICILLIN
Diagnostic Lab Data: 6/18/21
CDC Split Type:

Write-up: patient was admitted overnight to ER, found 2 embolism and was diagnosed with pulmonary embolism. being treated with blood thinners. discharged 6/19/21


VAERS ID: 1413086 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-03-31
Onset:2021-05-05
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Cough, Death, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-18
   Days after onset: 44
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 40 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin HCL, Glargine, Prazosin HCL, Metoprolol Tartrate, Lisinopril, Levothryroxine NA, Rovastatin, Divalporex, Seroquil, Hyrroxyzine, Fish Oil, Vitamin D3, Aspirin, Magnesium
Current Illness:
Preexisting Conditions: Diabetes, PTSD, Hypothyroidism, Hyperlipidemia, High blood pressure
Allergies: Dilantin
Diagnostic Lab Data: Covid test given in Emergency room on May 9, 2021.
CDC Split Type:

Write-up: Coughing started about May 5, 2021, confusion started on about May 8, 2021, put on oxygen in Emergency room on May 9, 2021. Admitted to hospital where he stayed until his death on June 18, 2021.


VAERS ID: 1413090 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-07
Onset:2021-06-11
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Arthralgia, Asthenia, Computerised tomogram normal, Decreased appetite, Dizziness, Electrocardiogram normal, Fatigue, Headache, Impaired work ability, Malaise, Migraine, Muscular weakness, Nausea, Pain, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine 75mcg
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: cat scan, ekg, 6/13/21, both came back ok
CDC Split Type:

Write-up: Patient received J and J covid vaccine on 3/7/21. She did not feel well for the next few days and had the following symptoms: headache, fatigue, nausea, body aches, loss of taste. She recovered after a few days and was doing well until 6/11/21. She began having the following symptoms: migraine headache, nausea, dizziness, loss of appetite, blurred vision, weakness, loss of taste, muscle weakness and joint pain. She went to ER on 6/13/21. They did a cat scan and ekg, both came back normal. They did not do a covid test. She then went to her regular Dr. on 6/15/21 and he gave her topiramate. He did not do a covid test. She was off work for a week and returned to work on 6/18/21. She is feeling better now and has worked for the last two days. She came to pharmacy and told me what was happening and she thinks that her symptoms are from the original J and J covid vaccine on 3/7/21 and she is worried that she may have recurring symptoms for the vaccine


VAERS ID: 1413283 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyskinesia, Eye movement disorder, Fatigue, Immediate post-injection reaction, Nausea, Seizure, Unresponsive to stimuli
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: None
Allergies: Hummus, chickpeas
Diagnostic Lab Data: Unknown- patient was taken to ER by ambulance once paramedics arrived.
CDC Split Type:

Write-up: Approximately 2-3 minutes after vaccine administration patient began having a seizure (convulsing/uncontrolled movements, random eye movements, unresponsive but conscious) in observation area chair. The paramedics were called immediately. The seizure lasted about a minute. The father was insistent that he get up and walk around. After 2-3 minutes he returned to his seat. Pharmacist attempted to take blood pressure reading. During blood pressure check the patient complained of fatigue and nausea and then began having another seizure. This also lasted about 1 minute. About 2 minutes later the paramedics arrived and took patient to ER.


VAERS ID: 1413336 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-31
Onset:2021-04-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood sodium decreased, Blood test normal, Bradycardia, Chest X-ray normal, Chest pain, Computerised tomogram thorax normal, Dyskinesia, Dyspnoea, Electrocardiogram normal, Fibrin D dimer increased, Full blood count normal, Gastrooesophageal reflux disease, Guillain-Barre syndrome, Head discomfort, Heart rate increased, Hypoaesthesia, Immunoglobulin therapy, Lumbar puncture, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, Magnetic resonance imaging spinal normal, Metabolic function test, Musculoskeletal stiffness, Nasal discomfort, Nervous system disorder, Neurological examination, Pain, Pain in extremity, Paraesthesia, Postural orthostatic tachycardia syndrome, Presyncope, Protein total increased, SARS-CoV-2 test negative, Spinal X-ray normal, Tachycardia, Throat irritation, Tremor, Troponin normal, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin, probiotic, occasional over the counter pain relief as needed (Tylenol, ibuprofen)
Current Illness: None
Preexisting Conditions: None
Allergies: Delayed skin reaction to CT contrast dye
Diagnostic Lab Data: 4/16 - CBC and metabolic panel; nothing notable, slightly low sodium 4/19 - spine X-ray - unremarkable; numerous blood tests, all normal, sodium back in range 4/22 - metabolic panel, normal; spinal MRI NORMAL 4/26 - EKG; numerous blood tests, all normal 4/27 - troponin normal; d dimer 866; Covid test negative; CT for pulmonary embolism negative 4/28 - CBC, troponin, metabolic panel, EKG all normal or close to range 4/29 - MRI head, cervical spine, and thoracic spine ; all came back no adverse findings 4/30 - lumbar puncture - tested for many things , but protein came back elevated ; led to GBS diagnosis 5/23 - many blood tests - d dimer elevated again at 1546; ultrasound for DVT negative for clots 5/24 - d dimer 1693; no other symptoms of PE so Ct/ VQ scan not recommended; orthostatics tested and showed increase of 30+ bpm upon standing 5/28 - numerous blood tests ; d dimer going down but still elevated at 1496 5/31 - numerous blood tests - normal or close to for all 6/14 - numerous blood tests all normal or close to 6/17 - chest X-ray normal
CDC Split Type:

Write-up: After receiving the vaccine on 3/31, experienced typical side effects noted such as sore arm, body aches, etc. - however two days after felt numbness and tingling in feet and hands which went away a few days later. On 4/14, the tingling in feet returned. Went to ER on 4/16 as tingling/numbness getting worse and progressing upward to legs; evaluated and sent home. Returned to ER on 4/22 as numbness/tingling continued to progress upward, evaluated and sent home. On 4/25, in addition to constant numbness/tingling, started experiencing tachycardia. Resting heart rate as well as heart rate doing simple tasks was high. Also began experiencing difficulty getting a full breath. Woke up 4/27 to worsening breathing and tachycardia, as well as new feelings of adrenaline rushes and Internal tremors throughout the body. PCP ordered Troponin and D Dimer and D Dimer elevated. Back to ER that day - negative Covid test - CT of chest showed no blood clots; sent home. That evening, resting heart rate was high and elevated even while lying down (90-110 bpm). The next day, 4/28, all symptoms continued and worsened as day progressed. Returned to ER and in the way experienced a pre syncope episode - upon arrival to ER blood pressure was 70/30; stabilized and sent home. Continued tachycardia and another pre-syncope episode that evening. Was referred to neurology and had appointment 4/29; all symptoms remained and were increasingly debilitating. Neurologist determined more testing needed, and was admitted to the hospital for observation/testing. Diagnosed with Guillain Barre Syndrome after head/neck/spine MRI and lumbar puncture, which showed elevated protein. Hospitalized for 5 day course of IVIG and discharged 5/4. Started feeling better for a few weeks, although numbness/tingling in legs/feet never went away. The week of 5/17 started feeling burning in throat/nose/chest and returning tachycardia; returned to ER 5/23, was admitted for observation as D Dimer high again - checked for DVT, all clear; testing and suspicion of Postural Orthostatic Tachycardia Syndrome (POTS); discharged 5/25. On evening of 5/30, experienced new concerning neurological tremors and sudden involuntary movements, as well as stiff neck/head. Returned to ER 5/31; evaluated and released. Have continued to experience autonomic nervous system dysfunction, POTS symptoms, tachycardia and bradycardia, constant numbness and tingling in extremities and occasional tingling/numbness in other areas in the body, pressure in head, internal tremors, adrenaline rushes, feelings of burning in throat/chest, suspected reflux; upcoming appointments with an Electrophysiologist and Neuromuscular Doctor for further evaluation. Note - also reported this using v-safe up until the weekly check ins were over


VAERS ID: 1413366 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Biopsy skin, Blood test, Myalgia, Pruritus, Rash, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: JANUMET; LISINOPRIL; GLIMEPIRIDE; ULORIC; PANTOPRAZOLE; ATORVASTATIN; METFORMIN
Current Illness: Alcohol use (occasional drink 1 per week if that or 1 or 2 drinks a month); Blood cholesterol abnormal; Blood pressure abnormal; Gout; Non-smoker; Stomach ulcer; Type II diabetes mellitus
Preexisting Conditions: Comments: Patient does not have known allergies. Patient does not have drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210518; Test Name: Blood test; Result Unstructured Data: Non-reactive for Lyme; Test Date: 20210518; Test Name: Skin biopsy; Result Unstructured Data: Insect related
CDC Split Type: USJNJFOC20210622233

Write-up: WEAKNESS; MUSCLE ACHES; SWELLING; ITCHING; RASH ON EXTREMITIES AND BACK ON THE LEFT SIDE; This spontaneous report received from a patient concerned a 68 year old male. The patient''s weight was 230 pounds, and height was 70 inches. The patient''s concurrent conditions included diabetes mellitus 2, alcohol user, non smoker, gout, stomach ulcers, cholesterol, and blood pressure, and other pre-existing medical conditions included patient does not have known allergies. patient does not have drug abuse or illicit drug usage.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 03-APR-2021 for prevention of covid-19. Concomitant medications included lisinopril for blood pressure, atorvastatin for cholesterol, glimepiride for diabetes mellitus 2, metformin for diabetes mellitus 2, metformin hydrochloride/sitagliptin phosphate monohydrate for diabetes mellitus 2, febuxostat for gout, and pantoprazole for stomach ulcers. On APR-2021, the subject experienced itching. On APR-2021, the subject experienced rash on extremities and back on the left side. On 29-APR-2021, the subject experienced swelling. On 06-MAY-2021, the subject experienced weakness. On 06-MAY-2021, the subject experienced muscle aches. On 18-MAY-2021, Laboratory data included: Blood test (NR: not provided) Non-reactive for Lyme, and Skin biopsy (NR: not provided) Insect related. Treatment medications (dates unspecified) included: triamcinolone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from swelling on 09-JUN-2021, was recovering from weakness, and muscle aches, had not recovered from rash on extremities and back on the left side, and the outcome of itching was not reported. This report was non-serious.


VAERS ID: 1413417 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Hypoaesthesia, Injection site pain, Magnetic resonance imaging, Muscular weakness, Neck pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: None
Allergies: no Allergies
Diagnostic Lab Data: mri, cat scan, blood work between April 12 to 14, 2021. Blood work with pcp in May 2021. Emg scheduled for Sept and neurologist wants lumbar puncture not yet scheduled
CDC Split Type:

Write-up: 2 days after shot, numbness/weakness in left leg and pins and needles in left hand. Upper arm pain where injection given. Neck pain. Seems to be autoimmune reaction. Hospitalized for 2 nights, seeing neurologist, having physical therapy for leg and neck


VAERS ID: 1413421 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 5 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT KNOW
Current Illness: NO
Preexisting Conditions: NOT KNOWN
Allergies: NO KNOWN ALLERGY
Diagnostic Lab Data:
CDC Split Type:

Write-up: AFTER GETTING SHOT , PATIENT WAS WAITING FOR 15 MINUTES. PATIENT FAINTED AND FELL ON FACE . CALLED 911 AND AMBULNACE CAME OVER, SHE WAS AWAKE AND RESPONDING. NEXT DAY ON DUTY RPH CALLED BOYFRIEND ( HE WAS WITH HER ON 06/19/20 VACCINATION TIME) AND FOUND OUT THAT SHE HAD ANXIETY FROM VACCINE


VAERS ID: 1413428 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache, Pain, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Headache, body ache, fever, severe chills, entire body shaking, hard to breath


VAERS ID: 1413516 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-06
Onset:2021-06-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Dysphagia, Flushing, Lip swelling, Pain in extremity, Parosmia, Peripheral swelling, Pharyngeal swelling, Swollen tongue
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Diphtheria vaccine. Age about 13 years. Fever, moderate anaphylaxis, hospitalised for 3 days.
Other Medications: Omeprazole Dr 40 MG Levothyroxine 112 MCG Albuterol HFA (Proair) Inhaler Epinephrine 0.3 MG (for Unknown Allergy) HRT Compound Estradiol 0.01% Cream Allegra-D
Current Illness: None
Preexisting Conditions: Hypothyroid Asthma
Allergies: Codeine Suxamethonium isonipecaine / Demerol Unknown Allergy
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: After vaccine was introduced felt slight swelling discomfort of left arm (had to remove and reseat my watch strap) followed by both arms seeming flushed (reddish). Ignored both symptoms at the time. About 30 minutes after vaccine on my way home in the car throat started feeling swollen and I found it difficult to swallow. Lips and tongue felt swollen (even though they didn''t loot it). Metallic taste in mouth and could smell a weird earthy smell. Went to ER to seek assistance, by the time I got to the ER symptoms were starting to subside. Kept under observation for the rest of the afternoon before being discharged Prescribed an EpiPen and followed up with Primary Care Physician. After about a week started feeling a pain deep in my right calf, no other symptoms so have not sought medical care. Today 2 weeks after vaccine still have slight pain in calf, seems to be subsiding with time.


VAERS ID: 1413717 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (Occasional drinker); Cancer; Diabetes; Nonsmoker
Preexisting Conditions: Comments: Patient has no known drug allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210522; Test Name: COVID-19 PCR test; Result Unstructured Data: NEGATIVE
CDC Split Type: USJNJFOC20210622942

Write-up: LOSS OF FEELING/NUMBNESS AT THE BOTTOM OF THE FEET; PINS AND NEEDLES AT THE BOTTOM OF FEET; This spontaneous report received from a patient concerned a 48 year old white female of non Hispanic/Latino origin. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes, cancer, alcoholic, and nonsmoker, and other pre-existing medical conditions included patient has no known drug allergy The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, and batch number: 1802068 expiry: UNKNOWN) on left arm, 1 total, dose was not reported, administered on left arm on 18-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-MAY-2021, the patient experienced loss of feeling/numbness and pins and needles at the bottom of her feet and it had progressed up to just below her breasts. On 22-MAY-2021, Laboratory data included: COVID-19 PCR test (NR: not provided) NEGATIVE. The patient was hospitalized on 26-MAY-2021 for three days and got discharged on 28-MAY-2021. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from loss of feeling/numbness at the bottom of the feet, and pins and needles at the bottom of feet. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210622942-COVID-19 VACCINE AD26.COV2.S-LOSS OF FEELING/NUMBNESS AT THE BOTTOM OF THE FEET, PINS AND NEEDLES AT THE BOTTOM OF FEET. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: UNDERLYING DISEASE


VAERS ID: 1413734 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-04-02
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Pain assessment, Sinusitis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no history of allergies or sinuses infections.
Allergies:
Diagnostic Lab Data: Test Date: 20210403; Test Name: Pain scale; Result Unstructured Data: 12 to 9; Test Date: 20210505; Test Name: CT scan; Result Unstructured Data: indicated sinusitis
CDC Split Type: USJNJFOC20210632795

Write-up: SINUSITIS; This spontaneous report received from a patient concerned a 55 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no history of allergies or sinuses infections.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 041A21A, expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-APR-2021, the subject experienced sinusitis. On 03-APR-2021, Laboratory data included: Pain scale (NR: not provided) 12 to 9. On 05-MAY-2021, Laboratory data included: CT scan (NR: not provided) indicated sinusitis. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from sinusitis. This report was non-serious.


VAERS ID: 1413740 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Feeling abnormal, Feeling cold, Hypokinesia, Pain in extremity, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210634067

Write-up: FREEZING COLD; HEAD WAS COLD LIKE ICE/SEEMED LIKE DYING; WHOLE BODY COULD NOT MOVE; SHAKING; SORE ARM; NO ENERGY; This spontaneous report received from a patient concerned a 41 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: 07-AUG-2021) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced sore arm. On 09-APR-2021, the subject experienced no energy. On 18-APR-2021, the subject experienced freezing cold. On 18-APR-2021, the subject experienced head was cold like ice/seemed like dying. On 18-APR-2021, the subject experienced whole body could not move. On 18-APR-2021, the subject experienced shaking. Treatment medications included: ibuprofen, and paracetamol. The action taken with covid-19 vaccine was not applicable. The patient was recovering from freezing cold, head was cold like ice/seemed like dying, whole body could not move, and shaking, and the outcome of sore arm and no energy was not reported. This report was non-serious.


VAERS ID: 1413755 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-05-27
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Paraesthesia, Photopsia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Essential hypertension, benign
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Contracted COVID in April)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210637053

Write-up: BLURRED VISION; FLASHY THINGS AROUND EYES; NUMBNESS ON RIGHT SIDE; TINGLING ON RIGHT SIDE; PAIN ON LEFT SIDE DOWN TO THE BASE OF SKULL/SEVERE HEADACHE (HEADACHE UNBEARABLE); This spontaneous report received from a patient concerned a 50 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included contracted covid, and concurrent conditions included benign hypertension. The patient experienced drug allergy when treated with metformin, and amlodipine besilate for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 27-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 27-MAY-2021, the subject experienced blurred vision. On 27-MAY-2021, the subject experienced flashy things around eyes. On 27-MAY-2021, the subject experienced numbness on right side. On 27-MAY-2021, the subject experienced tingling on right side. On 27-MAY-2021, the subject experienced pain on left side down to the base of skull/severe headache (headache unbearable). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from blurred vision, flashy things around eyes, pain on left side down to the base of skull/severe headache (headache unbearable), numbness on right side, and tingling on right side. This report was non-serious.; Sender''s Comments: V0:Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1413759 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 04A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Dizziness, Dyspnoea, Feeling abnormal, Lymphadenopathy, Peripheral venous disease, Urine abnormality
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Proteinuria (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Psoriatic arthritis
Preexisting Conditions: Medical History/Concurrent Conditions: Fever (fever for 10 days); Hypertension (The blood pressure was over 175 after receiving the steroid.); Tinnitus; Comments: The patient had experienced many adverse experiences with other vaccines/medications in the past. The patient had received steroids that resulted in bright pink torso and was aware about the steroid allergy. The patient thinks he had covid-19 back in December because he loss his sense of smell for 2 to 3 weeks. Patient received a vaccine 10 years ago that gave him a fever for 10 days straight.
Allergies:
Diagnostic Lab Data: Test Date: 20210521; Test Name: Blood pressure; Result Unstructured Data: 111/63; Test Date: 20210601; Test Name: Blood test; Result Unstructured Data: all clear
CDC Split Type: USJNJFOC20210637249

Write-up: SHORTNESS OF BREATH (FEELING CONSTRICTED BUT NOT COMPLETE LOSS OF BREATH); LEFT NECK LYMPH NODE SWELLING (NOW DECREASED IN SIZE, STILL PALPABLE AND INFLAMED); FEELS HYPOSTATIC; LIGHT HEADED; FEELING BACKED UP; CLOUDINESS IN URINE; This spontaneous report received from a patient concerned a 55 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included fever, tinnitus, and drug induced hypertension, and concurrent conditions included autoimmune disease -psoriatic arthritis, and other pre-existing medical conditions included the patient had experienced many adverse experiences with other vaccines/medications in the past. the patient had received steroids that resulted in bright pink torso and was aware about the steroid allergy. the patient thinks he had covid-19 back in december because he loss his sense of smell for 2 to 3 weeks. patient received a vaccine 10 years ago that gave him a fever for 10 days straight. The patient experienced hypertensive when treated with salbutamol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 04A21A, and expiry: 05/AUG/2021) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced cloudiness in urine. On 21-MAY-2021, the subject experienced shortness of breath (feeling constricted but not complete loss of breath). On 21-MAY-2021, the subject experienced left neck lymph node swelling (now decreased in size, still palpable and inflamed). On 21-MAY-2021, the subject experienced feels hypostatic. On 21-MAY-2021, the subject experienced light headed. On 21-MAY-2021, the subject experienced feeling backed up. On 01-JUN-2021, Laboratory data included: Blood test (NR: not provided) all clear. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) 111/63. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from shortness of breath (feeling constricted but not complete loss of breath), left neck lymph node swelling (now decreased in size, still palpable and inflamed), feels hypostatic, light headed, cloudiness in urine, and feeling backed up. This report was non-serious.


VAERS ID: 1413855 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-18
Onset:2021-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain, Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Headache, generalized body aches, mouth and face paresthesia


VAERS ID: 1414307 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood ethanol, Computerised tomogram head, Drug screen, Full blood count, Metabolic function test, Nausea, Seizure, Seizure like phenomena, Troponin, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Drug abuse and dependence (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: influenza: rash, shortness of breath, Tdap: rash, shortness of breath
Other Medications: Advair, aleve, androgel, benadryl, claritin, epipen, flonase, fluoxetine, hydroxyzine, multivitamin, singulair, ventolin
Current Illness: None
Preexisting Conditions: Female to male transition, asthma
Allergies: eggs, nuts, penicillins, ceclor, ibuprofen
Diagnostic Lab Data: CMP, CBC, EtOH, UDS, troponin, CT head
CDC Split Type:

Write-up: Patient started to experience nausea/vomiting soon after getting the vaccine, then started convulsing and having seizure-like symptoms.


VAERS ID: 1414345 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-06-21
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: pain 7/10


VAERS ID: 1414470 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-20
Onset:2021-06-17
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure decreased, Brain injury, Cerebellar stroke, Computerised tomogram, Injury, Magnetic resonance imaging, Seizure
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prozac
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct scans, mris.
CDC Split Type:

Write-up: Severe drop in blood presure leading to waterfall stroke and seizure. According to neurologist brain damage is permanent and non reversible.


VAERS ID: 1414499 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-06-17
Onset:2021-06-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: urgent care visit on 6-22-21
CDC Split Type:

Write-up: Fever (100.2), muscle pain, headache, minor chest pain.


VAERS ID: 1414611 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-06-21
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Eye pain, Fatigue, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium+vitamin D Estradiol Valerate Tylenol
Current Illness: none reported by patient
Preexisting Conditions: GAD
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had her Janssen vaccine on 04/10/2021. She is currently c/o blurred vision, headaches with left eye pain, and thoracic back pain since she received her vaccine. She reports the headaches and back pain as a 10/10 on the numeric pain scale despite taking OTC medications. She says she attempted to come in as a same-day walk-in last week but the wait was too long and she left home. She denies any nausea or vomiting but says that these are the worst headaches of her life and that she never had these headaches prior to the vaccine. She is also c/o extreme fatigue. She denies any fevers, CP, or SOB


VAERS ID: 1414639 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-06-17
Onset:2021-06-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil
Current Illness:
Preexisting Conditions: ADHD, asthma, heartburn
Allergies: Bactrim, Biaxin, Versed, gluten, turkey, cats
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Red spots across shoulders (petechiae)


VAERS ID: 1415007 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-13
Onset:2021-06-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inflammation, Rash, Rash pruritic, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Full body burning rash spread over my entire body over the course of about 24 hours. It started around my ankles and lower legs (Thursday night) which made me initially think something had bitten me in my sleep. However it progressed rapidly throughout the day Friday to the point where my palms and the soles of my feet were raging with burn. my arms, top of hands, fingers, legs, top of feet, all were covered and burning/itching. I finally went to the hospital after trying topical creams with no success.


VAERS ID: 1415036 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207 A21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Laboratory test normal, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Prior allergic response to vaccines
Diagnostic Lab Data: Tested at emergency room 6/21/2021 - tests within normal values.
CDC Split Type:

Write-up: Chest tightness, dizziness, heart pounding


VAERS ID: 1415064 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-18
Onset:2021-05-31
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphonia, Asthenia, Body temperature increased, Cough, Ear discomfort, Fatigue, Hypoacusis, Illness, Oropharyngeal discomfort, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescriptions: Gabapentin; Synthroid; Tramadol; B12 Pill
Current Illness: No
Preexisting Conditions: Reflux Sympathetic Dystrophy over 20 years left leg, foot and ankle
Allergies: Shellfish; sulfa
Diagnostic Lab Data: Negative for COVID At Urgent care
CDC Split Type: vsafe

Write-up: I had a really severe sore throat; I lost my voice for awhile. Water on my ears and 101 degree temperature. Runny nose really bad. There was drainage down my throat from runny nose. Feeling really weak and tired. Really deep down in my lungs cough. I was sick for about five days and then went to Urgent Care; Cough medicine and Z-Pak Antibiotic that helped with all except the water in my ears. That hasn''t gone away yet so my hearing is a little off. The cough lasted for about two and 1/2 weeks but is gone now. I cough every once in a while, but not bad. I may go back to the Urgent care for my ears.


VAERS ID: 1415069 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-14
Onset:2021-06-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Fall, Head injury, Loss of consciousness, Nervousness, Skin laceration, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Not after a vaccine but giving blood as described earlier than in the report
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Fainted after giving blood less than 6 months ago. Hadn''t eaten before that, hadn''t eaten before this one. Described anxiety as well prior to administration.
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Last week Monday - June 14 I worked 1pm-9pm. My opening pharmacist left around I''d say 2pm, or 2:15pm~ish and hadn''t witnessed the incident. So somewhere around that approximate time I was inside the pharmacy working on a back computer by drive thru and I heard someone yell for help in the waiting area. It was the kind of help you just know means something really drastic has just occurred. I quickly entered the waiting area via the pharmacy consultation door and saw patient face down between two chairs and his nose had a consistent drip of blood that was apparent on the floor. My technician who was in the consultation room told me he had received a Johnson and Johnson Covid vaccine probably within 5 minutes of the incident. With the combination of that information and the visualization of an active bleed, I made eye contact with another staff member inside the pharmacy at will call and told him to call 911 which he turned around immediately and did. The man was alone, but the woman who yelled for help was also calling 911 I believe. At this point I''d say approximately every 3 seconds, a new drop of blood would emerge. There were a couple people nearby including the customer and I asked everyone to stay back a little, I surveyed the scene and it appeared to be safe and I approached patient as I tried to verbally get a response of some sort. I asked if he could hear me, if he knew where he was and what happened, both with no response. The bystander recommended turning him on his side but with the unknown cause of the bleed and the recent vaccination I didn''t know if it could be CNS or spinal related and since we were on the phone with EMS, we could get their recommendation of whether to move him or not. Within 15-30 seconds probably, he started regaining consciousness and he was scared at first and rightfully so. He jolted up and back and looked at me like, "why am I face down in my own blood (and probably in a lot of pain i''m sure)", and it scared me a little to be honest. I told him what we had observed, and I saw the bridge of his nose stuck out beyond what was normal but I''m not sure what normal is to him..?? I saw two small lacerations on the side of his nose and a pair of glasses on the floor. I couldn''t determine if they were broken or not but surmised, he must have fainted and fallen off the chair and landed on his glasses which cut and may have even broken his nose. Or maybe the ground broke his nose. Either way it looked bad. There were several store team members around at this point (those listed in this report), and the patient was given paper towels for the bleeding and bottled water. There was a store use wheelchair we put him in when he was ready and wheeled him into the consultation room where he could be monitored until EMS arrived. While speaking with the patient before EMS arrived, he rendered all the following information: Never had a reaction to a vaccine before Never had any knowledge of high or low BP issues Doesn''t recall ever feeling lightheaded or dizzy upon quickly erecting Might have low blood sugar issues Reasonings for the above response: Hadn''t eaten that day yet before his shot and was feeling a little anxious about it Last time he gave blood he hadn''t eaten breakfast and passed out after that This was the only other fainting history mentioned He did say it was within the last 6 months EMS arrived within another 2-3 minutes I''d say at which time we had already began the cleaning process. We blocked off the area to other customers, we halted the vaccination process until the issue was resolved, I printed the Biohazard Spill procedures, we obtained the bio-hazard spill kit, and proceeded to clean with all the PPE and sanitization materials included within the kit. After the entire process was completed the store team even ran the cleaner over the area to go above and beyond. The patient refused the ride to the hospital via ambulance due to costs and signed a medical waiver I believe..??


VAERS ID: 1415179 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Blood glucose, Dizziness, Electrocardiogram, Head injury, Joint contracture, Loss of consciousness, Miosis, Syncope, Tachypnoea, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient denies taking any medications, dietary supplements, or herbal remedies at time of vaccination.
Current Illness: Patient denies any illness recently
Preexisting Conditions: Patient denies any past medical history.
Allergies: Denies any allergies to medications, food or other products.
Diagnostic Lab Data: NA. No medical lab tests related to adverse event.
CDC Split Type:

Write-up: Pt w/o medical hx/drug allergies presents with syncope in observation area s/p J&J injection. Patient stood up with dizziness and loss consciousness with head injury on counter. (Estimated 10 Seconds KO). Upon arousal pt presents tachypnea, pin-point pupils, hand contractions, one episode of vomiting, loss of memory. Orientated to name/dob although does not know location or recollection of receiving vaccine. EMS called responding to seen. Initial VS: BP: 86/55, O2: 96%, HR 81. Paramedics responding on scene EKG/BS checked patient taken to . Pt stabilized and transported with AMR paramedics to .


VAERS ID: 1415184 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-22
Onset:2021-04-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin 10 mg , Losartan Potassium 50mg, COQ 10, Vitamin D 1000 iu, Multivitam
Current Illness: None
Preexisting Conditions: High Blood Pressure and High Cholesterol
Allergies: None
Diagnostic Lab Data: April 12th 2021, EKG - Atrial Fibrillation
CDC Split Type:

Write-up: I had Atrial Fibrillation on the morning of Apr 12th. I have never had any Afib before this event. My heart was in AFIB for about 3 hours when it returned to normal by itself. I had to go to the emergency room where they took my EKG and was diagnosed as AFIB by my cardiologist (contacts above)


VAERS ID: 1415217 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-16
Onset:2021-06-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN WM5497 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: Chest pain, shortness of breath, elevated heart rate


VAERS ID: 1415230 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-16
Onset:2021-06-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dizziness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Patient experienced chest pressure and dizziness 2 days after receiving the Johnson & Johnson vaccine.


VAERS ID: 1415312 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, 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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: PATIENT APPEARED LIGHTHEADED THEN SEEMED TO PASS OUT FOR 8 TO 10 SECONDS WITHIN 2 TO 3 MINUTES OF THE VACCINE BEING ADMINISTERED. HE CAME TO AND WAS ABLE TO SPEAK TO THE EMS STAFF WHEN THEY ARRIVED. PATIENT WAS TAKEN TO ER FOR EVALUATION.


VAERS ID: 1415363 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-29
Onset:2021-06-07
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZIA / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro & hydroxizine
Current Illness: None
Preexisting Conditions: None
Allergies: Nuts, alcohol, mango
Diagnostic Lab Data: Multiple ultrasounds
CDC Split Type:

Write-up: DVT in right calf, treating with blood thinners


VAERS ID: 1415379 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia, Chest discomfort, Dizziness, Dyspnoea, Electrocardiogram abnormal, Feeling drunk, Hypertension, Malaise, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Not at the time; now I know that I am allergic to polysorbate 80
Diagnostic Lab Data: EKG-Arrhythmia
CDC Split Type: vsafe

Write-up: Right away after having the vaccine I felt dizzy and I told the staff that I was not feeling that well and they took my blood pressure and it was high and they kept taking it every 10 minutes or so and it kept increasing. After 45 minutes it began to level down and they sent me home but even before getting to the parking lot I started shaking and I was out of breath. They gave me epinephrine and they called 911. They took me to the hospital, and they told me I have an arrhythmia. They did an EKG. They let me go my home. Since that day my blood pressure has been high and my doctor put me on blood pressure medication. The day before having the vaccine I had a physical done and my blood pressure has been always on the low side but now it is still high. Now I am being treated for new symptoms, which are chest pressure accompanied with shortness of breath and dizziness. The dizziness its scary because sometimes I drive and I feel like a drunk person driving which is not right and not safe.


VAERS ID: 1415405 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

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

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

Write-up: patient alerted the technician that the patient stated he felt like he was going to pass out. He was visually sweating, clammy, and bending over. The pharmacist then instructed the patient to lean back in his chair and to breathe. next he started to lean to his side to pass out so the pharmacist grabbed him and held him up, the patient was unaware that he passed out. the patient was passed out for about 20 seconds and may have had a small seizure with no history of seizures on file. we applied a cold pack on the patient to help with the nausea he then dry heaved into the trash can. ems arrived and took patient to the hospital.


VAERS ID: 1415472 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Electromyogram, Immunoglobulin therapy, Lumbar puncture, Magnetic resonance imaging, Multifocal motor neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: HYPERTENSION
Allergies: NONE
Diagnostic Lab Data: SPINAL TAP, MRI AND HOSPITALIZATION 5/28/2021 - 6/2/2021 , EMG 5/18/2021
CDC Split Type:

Write-up: MULTIFOCAL MOTOR NEUROPATHY PATIENT IS BEING GIVEN IV-IG TREATEMENTS THAT WILL CONTINUE OVER THE NEXT 24 MONTHS


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