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

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



Case Details (Reverse Sorted by Onset Date)

This is page 60 out of 1,889

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VAERS ID: 1194561 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Hyperhidrosis, Nausea, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: about 5 minutes after vaccine, patient became pale, hot, sweaty, nauseous and lightheaded. He vomited once.


VAERS ID: 1194587 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RL / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Contusion, Fall, Feeling hot, Haemorrhage, Head injury, Hyperhidrosis, Loss of consciousness, Pallor
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), 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? No
Hospitalized? No
Previous Vaccinations: patient mentioned that after the incident
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt walked over and sat down in waiting area. Within 2 minutes he lost consciousness, fell out of his chair, hit his head on the floor. this lead to bleeding/ bump on left eyebrow. Pt was hot, sweaty, clammy, and pale. he laid on floor with feet raised for a few minutes. He felt better in about 15 minutes, parents arrived to drive him home.


VAERS ID: 1194591 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: flecanide , lisinopril, toprol xl, xarelto ,aspirin
Current Illness: none
Preexisting Conditions: afib
Allergies: none
Diagnostic Lab Data: ems response, ran ekg, patient refused transport
CDC Split Type:

Write-up: syncopal episode


VAERS ID: 1194598 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Skin warm
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: m/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Dizzy and warm right after the shot for about 15 minutes


VAERS ID: 1194599 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Patient passed out, opened ammonia salt within 2 minutes, pt lost responsiveness after 7 minutes, gave Epipen, called EMS. Patient observed for additional 15 minutes, BP and HR stable per EMS review.


VAERS ID: 1194622 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO KNOWN
Current Illness: NONE KNOWN
Preexisting Conditions: NONE KNOWN
Allergies: NKDA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT GOT LIGHT HEADED AND PASSED OUT


VAERS ID: 1194624 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Headache, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, vitamin C, zinc, birth control, metformin, zyrtec
Current Illness: None
Preexisting Conditions: PCOS and Metabolic Syndrome
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, nausea, muscle aches and body pains, headache, weakness. Treated fever with ibuprofen and rest. Since 4:00am on April 11.


VAERS ID: 1194632 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 immediately became flushed and red and was sweating profusely. Lied on the ground. Declined to get Epipen from pharmacist. Was not feeling well for up to 25 minutes after and then left with EMTs to the hospital.


VAERS ID: 1194642 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, 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), Dementia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client felt light headed and dizzy approximately 3-5 minutes following vaccination. Loss of consciousness, fell from chair in observation area. Regained consciousness approximately 1 min. later. Assisted to cot with legs elevated. Vitals obtained by on-site EMS. Vitals: @ 1605 HR 53, Spo298%, BP 159/88 initially. Continued to monitor last vitals 143/80, HR 56, SPO2 98%. Client denies ongoing dizziness or feeling faint. Client able to sit, stand, and walk without symptoms. Client left site in stable condition.


VAERS ID: 1194657 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: PATIENT GOT THE VACCINED AT 130PM COMPLAINED OF ITCHY THROAT, COUGH AND MILD THROAT TIGHTNESS AT 140PM DOCTOR EVALUATED THE PATIENT , NO RESPIRATORY DISTRESS, TALKING IN FULL SENTENCES. BENADRYL 50MG IM ADMINISTERED AT 203PM. MD EVALUATED THE PATIENT 5 MINUTES LATER AND PATIENT DENIED THROAT TIGHTNESS, ITCH OR COUGH. VS STABLE AT 140PM BP 110/65 HR 80 O2 96% VS AT 223PM 106/64 HR 74 O2 96% PATIENT WAS OBERSEVED FOR HALF HOUR AND SENT HOME WITH INSTRUCTIONS TO CALL 911 IF HE DEVELOPS ANY RESPIRATORY DIFFICULTY. PATIENT VERBALIZED UNDERSTANDING


VAERS ID: 1194660 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Drooling, Feeling hot, Hyperhidrosis, Immunisation anxiety related reaction, Pallor, Presyncope, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), 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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: shot for TMJ in jaw in 2010
Other Medications: Levothyroxine, Escitalopram, Oxybutinin, Omeprazole, Folic Acid, Vit D, Tramadol, Albuterol, Methotrexate
Current Illness: hypothyroid, Rheumatoid Arthritis, Chronic pain, HTN, Fibromyalgia, Osteoarthritis, Pre DM, Anxiety, Asthma
Preexisting Conditions: listed above
Allergies: Augmentin
Diagnostic Lab Data: VS, Monitored at side. transferred care to EMS
CDC Split Type:

Write-up: pt received J&J vaccine. Registrar talking to pt 3 min then pt stated "I feel warm dizzy like I''m going to pass out". Pt became pale, diaphoretic, warm dizzy - vaccinator put ice pack to back of neck and gave water to hydrate while sipping water pt drooled water out of mouth. pt was shaking and sliding down in chair, ammonia salts were used . Medical evaluator called - pt had vasovagal near syncopal episode. Staff moved her to cot no facial or tongue swelling noted. no LOC increased breathing VS 160/80, HR 88, resp 22 non labored. Medical evaluator NP at side Ice pack to neck, arm pits between legs to cool down. Pt stated very anxious about getting vaccine. family present. Pt stated this happened in 2010 when she received an injection for TMJ. Provided reassurance to calm pt down. EMS called - FD responded transferred care to EMS transported pt to hospital at approx 12:30 pm. 4/11/21 called husband to check on condition no answer no call back as yet


VAERS ID: 1194665 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro Adderall
Current Illness:
Preexisting Conditions: Depression ADHD
Allergies: Occasional pollen hives (this year was the occasional year)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Completely covered in hives. Arms, legs, back, neck, face, feet. Allegy medicine doing little to stop break out despite using two claritin 24hour medicine (recommended dose 1).


VAERS ID: 1194670 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: patient is under 18 and was administered the J and J vaccine


VAERS ID: 1194673 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / SYR

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

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

Write-up: High fever of 106. I took Tylenol and place a cold washcloth on my forehead and went down to 102 went to sleep. In the morning my fever was gone.


VAERS ID: 1194677 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Fall, Head injury, Heart rate decreased, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: BP 123/70
CDC Split Type:

Write-up: Patient fainted within a minute of getting the vaccine. She walked to her seat in the observation area. She was unware she fainted. Her BP was 123/70. She said she felt fine she had scratched her face and hit her head when she fell on the floor. 911 was called immediately. They took her out to the ambulance because her HR was low and she eventually left on her own accord


VAERS ID: 1194680 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Transient hypotension and bradycardia.


VAERS ID: 1194690 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Lip swelling, Pallor
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient was observed for 15 minutes; complained lips felt swollen had patient take off mask lips appeared normal, Patient was a bit pale and said she might faint. Rushed to her and held her avoiding fall. Patient closed he eyes for 1 to 2 seconds and responded to taps on the chest and calling her name. Opened her eyes, patient had pulse and was coherent.Called 911, police arrived within 10 minutes. In the mean time store management was alerted and BP was taken 157/121. EMS came and patient stated she was better they checked her BP 121/70. Patient refused to go to the hospital. EMS walked her out to her husband waiting in the car.


VAERS ID: 1194694 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: celiac disease
Allergies: Sulfa and gluten
Diagnostic Lab Data: BP 123/70
CDC Split Type:

Write-up: Patient walked to her seat in the observation ear and sat down. Within 1 minute she jerked back and fell to her right side hitting her head and face on the glasses display and landing sprawled out on the floor. She had her eyes wide open. She was not aware she fainted and was completely conscious. Her blood pressure was 123/70. 911 was immediately called. The EMTs took her to the ambulance due to low heart rate when they arrived. She ended up leaving on her own accord


VAERS ID: 1194703 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal
SMQs:, Dementia (broad)

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

Write-up: PATIENT GOT JANSSEN COVID-19 VACCINE @ 12:58 AND CAME BACK TO THE PHARMACY AT ABOUT 13:50 WITH A COMPLAINTS OF NOT FEELING GOOD . THE STORE ASSOCIATES CALLED 911 AND PATIENT WAS SUPPORTED BEFORE SHE WAS TAKEN TO THE HOSPITAL PATIENT WAS RESPONDING WHEN THE EMS CAME.


VAERS ID: 1194712 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Sign/Symptoms: vomiting, nausea, and diarrhea. Took one bite of sandwich and pickle from Wendy''s prior to vaccine and she vomited prior to getting the vaccine.


VAERS ID: 1194732 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN ER8733 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Pt had signed up for a vaccine on 3/22/2021 and scheduled a follow up injection (2 part series) for 4/11/2021. The pt no-showed the appointment and did not cancel it. The pt made another 1st dose appointment on 3/31/2021 and did arrive at that appointment to receive his vaccine. However, he also arrived at his 2nd vaccine dose appointment on 4/11/2021 as he had still not cancelled it. He checked in and received the vaccine. IT has been made aware of this glitch after the pt was discovered to be vaccinated and has already acted on it, cancelling all no show appointments so that it won''t t happen again.


VAERS ID: 1194740 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, headache, chill, fatigue and chest pain


VAERS ID: 1194753 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient fainted 3 mins after IM injection


VAERS ID: 1194763 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fear of injection, Hyperhidrosis, Pallor, Vital signs measurement
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills (unknown of name of pills) 1 spoonful of honey daily (for seasonal allergies)
Current Illness: none
Preexisting Conditions:
Allergies: seasonal allergies
Diagnostic Lab Data: VS listed above , monitored 30 minutes in recovery
CDC Split Type:

Write-up: While at recovery after 3 minutes pt complained of dizziness, became pale diaphoretic. put pt on cot to lie down feet elevated with ice pack to back of neck. no LOC no SOB no NV VS taken 116/78, HR 68 reg strong, resp 12 reg non labored. pt stated she is afraid of needles. Also stated she didn''t eat anything all day. Monitored for 30 min. pallor, diaphoresis and dizziness subsided. Provided reassurance sat for 30 minutes. stated I feel fine now. OKd to exit


VAERS ID: 1194771 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose abnormal, Malaise, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient had blood sugar readings in the excess of 400 mg/dL and was feeling ill, she fainted and was transported to the hospital.


VAERS ID: 1194772 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Fibrin D dimer increased, Hypoxia, Presyncope, Pulmonary embolism
SMQs:, Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Carbdopa/Levidopa 25 mg:100 mg Donepezil 10 mg
Current Illness: none
Preexisting Conditions: parkinson''s
Allergies: nkda
Diagnostic Lab Data: elevated d-dimer and XCT angio chets to confirm diagnosis
CDC Split Type:

Write-up: less than 2 days after second Pfizer vaccine near syncope, hypoxic aND DEVELOPED SUBMASSIVE PULMONARY EMBOLISM. NO OTHER KNOWN RISK FACTORS OR ACUTE EVENTS FOR CAUSE OF Pulmonary embolism and no prior dvt/pe


VAERS ID: 1194791 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: patient fainted; light headed, dizzy, sweaty and nauseous for about 5 minutes watched patient closely, used ice pack, gave water .patient was fine after


VAERS ID: 1194794 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Foaming at mouth, Headache, Hot flush, Joint stiffness, Pain, Photophobia
SMQs:, Convulsions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Standard Process brand: MediHerb Digest Forte, Enzycore, Zypan, Adrenal Tonic Photosynergist, Drenamin, Thyroid Complex, Cataplex G, MediHerb Thyroid Complex; APEX Energetics brand: GabaTone, Adaptocrine, Resveratrol, Liqua-D, EnteroVite,
Current Illness: N/A
Preexisting Conditions: Hashimoto?s subclinical, high cholesterol, anxiety
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Headache, light sensitivity, tight shoulder and neck muscles, skin feels light pain when touched, full body muscle aches, fatigue, brain fog, chills, hot flashes


VAERS ID: 1194795 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus unknown how long ago
Other Medications: none
Current Illness: "Pathological fear of needles" Ehlers-Danlos Disorder (extended ligaments)
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: VS listed above
CDC Split Type:

Write-up: While at recovery pt complained of dizziness, became pale and diaphoretic. Immediately sat pt on floor( refused to elevate feet). leaned against wall with ice pack to back of neck , water for hydration. no LOC no SOB no N/V. VS taken 130/72, HR 98 reg strong, resp 16 reg non labored, SopO2 97% Pt stated this happened before with tetanus shot a long time ago. Monitored 30 minutes. Provided reassurance pt stated I feel fine now. OKd to exit


VAERS ID: 1194802 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hallucination, auditory, Hyperhidrosis, Limb discomfort, Nausea, Pallor, Visual impairment
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Diziness, Sweating, Visual disturbance, Heavy arm, Pale, Hearing disturbance (hearing voices), Nauseated


VAERS ID: 1194806 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Pt stated he was nervous about drs office/vaccines. Shortly after (1 or 2 mins) patient got shot he got warm around the face and said he felt slightly dizzy. So we laid him on his back and elevated his feet. We put cold compress around his neck. This only lasted about 5-10 mins. Called pt couple hours later with no concerns.


VAERS ID: 1194807 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperhidrosis, Loss of consciousness, Muscle rigidity, Muscle twitching, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pale, diaphoretic rigid, twitching, unconscious, syncope episode, EMS was called and patient was transported


VAERS ID: 1194813 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Transient hypotension and bradycardia.


VAERS ID: 1194821 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

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

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

Write-up: patient developed rash, had no cp or sob bp 137/87 r 18 p 86 patient given Benadryl symptoms resolved


VAERS ID: 1194824 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-08
Onset:2021-04-11
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: asa lasix lopressor omeprazole potassium tolterodine vit d
Current Illness: none
Preexisting Conditions: htn
Allergies: sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: nob ST MI


VAERS ID: 1194833 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: syncopal episode, clammy, diapohoretic was given water and granola bar


VAERS ID: 1194841 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

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

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

Write-up: rash on face,


VAERS ID: 1194843 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: After 10 minutes of getting Janssen injection patient said they felt like they were going to pass out. Pharmacist had patient lay on their back with feet elevated and had store management apply cold compress to patient wrist and neck. Patient said they felt a little better but had ambulance called to check vitals. Management do not know results of vitals check but patient did leave store on their own accord after vitals were checked by EMT.


VAERS ID: 1194855 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Immediate post-injection reaction, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)

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

Write-up: Patient got dizzy and threw up immediately after receiving vaccine. Very pale. After drinking water and relaxing felt okay, Stayed for 15 minutes and still felt okay


VAERS ID: 1194857 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Dizziness, Laboratory test, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), 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: Tylenol
Current Illness: Previous diarrhea within last week
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct scan, chest X-ray, blood work
CDC Split Type:

Write-up: Fainting, nausea, lightheaded


VAERS ID: 1194858 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Heart rate increased, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: I had a reaction within 25 mins of J&J vaccine injection- my heart rate quickly went from 100 to 160 which is very abnormal for me and both of my hands were tingling (as were my feet). I felt a little dizzy and it was getting harder to breathe. It lasted for maybe 5- 10 mins and I had to try and do deep breathing techniques which helped a little. It has been almost 5 hours since my vaccine injection and I feel fine.


VAERS ID: 1194871 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

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

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

Write-up: SYNCOPAL EPISODE POSE COVID VACCINATION WITH JANSSEN COVID 19


VAERS ID: 1194886 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

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

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

Write-up: SYNCOPAL EPISODE POST VACCINATION


VAERS ID: 1194914 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Fatigue, Injection site pain, Joint swelling, Sleep disorder
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR 20mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Roughly 10 hours after injection, moderate muscular pain at injection site, and severe pain in old lower back injury - chronic bulging disc. Back pain onset was severe enough to wake me up from sleep and persisted despite use of OTC pain management. Used 2x extra-strength 500mg acetaminophen, only dulled pain, then 600mg ibuprofen approximately 8 hours later to same result. As of 27 hours post injection, pain is still moderate and disruptive. Lack of sleep and pain make it hard to determine if the fatigue is a unique symptom or purely the result of the pain symptoms. In a non-measurable manner, having had this back injury for over 10 years with multiple reoccurrences, it feels like the joint/disk swelled enough for it to press on the spinal nerves despite attempts to mitigate with ice, elevating feet and head to open intervertebral space.


VAERS ID: 1194922 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Body temperature decreased, Chills, Nausea, Neck pain, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Arthritis (broad)

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

Write-up: Burning pain, waves of body Chills, left side neck pain, headache, slight nausea. Had a Blood Pressure check immediately and temperature check (97.1), waited for a longer period at facility to make sure I was OK. blood pressure was extremely high at first reading (I''ve never had such a high reading in my entire life); blood pressure was within normal limits on second check (127/85), and I was well enough to leave. The chills come in waves, with continued slight nausea.


VAERS ID: 1194928 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

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

Write-up: Fever 100.2 at 3:00 am, Fever 100.5 at 3:30pm Tylenol was taken and warm bath was taken. Repeated body ache and chills throughout course of day beginning at 12:00pm to present time.


VAERS ID: 1194943 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Transient hypotension and bradycardia.


VAERS ID: 1194951 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chills, Impaired work ability, Retching, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not on any meds at home
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was extremely anxious prior to receiving COVID vaccine. After 30 minutes of administration, vomiting occurred. Dry heaving followed. Did not have an allergic reaction. Did not need to call 9-1-1. Just worked himself up so much about it. Sent him home as I didn''t want him to complete his shift while vomiting. Was having chills and wasn''t sure how long they were going to last. Left him to go home with girlfriend. Went out front to wait for his ride and get some fresh air. Exchanged numbers so I could keep in contact with him. Knows to contact EMS if symptoms worsen.


VAERS ID: 1194952 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Cold sweat, Dizziness, Heart rate, Hyperhidrosis, Nausea, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient reported feeling a little dizzy and nauseated after being vaccinated with girlfriend Patient soon after had syncopal episode Patient appeared clammy and pale and diaphoretic Patient seen by medical team Blood pressure 91/45 and heart rate 61 Patient provided water and repeat BP was 109/61 Patient refused medical transport and signed ama form but will have girlfriend drive him to hospital


VAERS ID: 1194953 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: About 10 minutes after shot I asked patient how he was feeling, he said he was hot. I walked out to talk to him and he said he felt dizzy. He turned pale and fell sideways off chair onto floor lowering himself with his knee. He did not bump his head, he was sweating profusely, but did not lose consciousness. I yelled to the tech to call 911. Patient was sitting on floor. He said he did not eat much all day. He was alert and talking. He said he fainted when his wife had their baby. We gave his some orange juice. The paramedics arrived 8 minutes later and checked his vitals. In the meantime we called his wife. Paramedics checked his BP, glucose and questioned patient. Patient refuse to go with paramedics. Wife came and paramedics released him to her.


VAERS ID: 1194954 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Night sweats, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Natalia, Pataday ophthalmic drops, Allegra
Current Illness: keratoconjunctivitis
Preexisting Conditions: W.P.W. syndrome, adenomyosis, endometriosis
Allergies: Penicillin, thimerosal, lidocaine, Ciprofloxacin, neomycin, potassium bichromate, Cobalt Chloride, strawberry, garlic, onions.
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever (102.4 F), body aches, chills, night sweats, mild nausea, mild sore throat, very strong headache


VAERS ID: 1194957 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-04-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Lymph node pain, Mobility decreased, Neck pain, Pain, Rash, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 8:00am. Sunday, april 11th woke up with extremely sore neck on the right side. It became visibly swollen over the day and unable to turn my head without extreme pain. The lymph node in the area is extremely tender and warm to the touch. Around 5:30 a rash started occuring on the neck where it is swollen. All of this is occuring on the opposite side of where the injection was given. No other side effects have been noticed through out the days after the injection until today.


VAERS ID: 1194962 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abnormal behaviour, Body temperature increased, Feeling hot, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 15. Chicken pox vaccine, 18 flu shot
Other Medications: Klonopin, lamictal, risperidone, vit c, vit d, Advil given at 5 pm 4/11/21 due to 99.3 temp
Current Illness: None
Preexisting Conditions: Angelman Syndrome, seizure disorder, developmental delay, non verbal
Allergies: Sulfa, dilantin, morphine, codeine,, cipro
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 5pm felt warm, temp at 99.3. clingy behavior. Gave one advil, settled down. Advil relieved his behavior. Ate dinner, off balance afterwards, fell asleep..possible seizure activity occurred 6pm. I increased his klonopin by .5mg. To monitor.


VAERS ID: 1194990 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Transient hypotension and bradycardia


VAERS ID: 1194997 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Gastrointestinal pain, Hypoaesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline Hyclate 100mg Mirena
Current Illness: Had a cold a week ago.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness in wrist and arm that was vaccinated after running and then while using a computer (this has never happened to me before). Also, I had digestive pain.


VAERS ID: 1194999 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Feeling cold, Headache, Heavy menstrual bleeding, Menstrual disorder, Myalgia, Nausea, Pain, Pyrexia, Renal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Within 7 hours had chills, muscle and body aches, fever, severe headache, abdominal and kidney pain, nausea. Within 27 hours of dose got my menstrual period 2 weeks early with a very heavy flow, despite being on birth control.


VAERS ID: 1195003 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspepsia, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft Lamictal Dexedrine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heartburn and a burning pain in my chest that?s making me drink more fluids.


VAERS ID: 1195012 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Hyperhidrosis, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZENATANE 40MG
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: FIVE MINUTES AFTER ADMINSTRATION OF THE VACCINE, PATIENT BECAME VERY DIZZY,FELT EXTREMELY HOT, SWEATY AND BECAME UNCONCIOUS FOR ABOUT 2MINS.


VAERS ID: 1195019 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Transient hypotension and bradycardia


VAERS ID: 1195022 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Patient became dizzy and fainted on the way to the observation chair. He did not lose conciousness, he said he just felt very dizzy. He said it felt good to lay on the ground, so I him lay for 5 minutes, then I helped him to a chair. I told him I wanted him to stay seated for 30 minutes so I can monitor him. He called his father, who came to pick him up after the 30 minutes were up. He slowly stood up and walked a few steps and then left the store with his father.


VAERS ID: 1195029 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dysgeusia, Salivary hypersecretion, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diovan 320mg, HCTZ 12.5mg, Centrum multivitamin, Claritin, Ashwaghanda
Current Illness: N/A
Preexisting Conditions: Hypertension History of breast cancer
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Metallic taste in mouth 14mins after injection. Minor tongue swelling, increased saliva production. Resolved within 3hours. No treatment or other medical intervention required.


VAERS ID: 1195033 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone, Escitalopram, Abilify, Trokendi
Current Illness: None
Preexisting Conditions: Migraine headaches, anxiety, Depression, Autism Spectrum Disorder
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bell?s Palsy, right side of face


VAERS ID: 1195055 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN COVID-1 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1 - Amlodipine-Valsartan 10/320 mg 1 - Atorvastatin 20 mg As needed - Omeprazole DR 20mg 1 - Aspirin 81mg 1 - Eliquis 5mg 1 - Finasteride 5mg 2 - Tamsulosin HCL .4mg
Current Illness: None
Preexisting Conditions: HBP
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, sore arm, muscle aches


VAERS ID: 1195068 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fall, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient stood up quickly from waiting area and fell back into chair. Patient diaphoretic and dizzy. Patient lay prone on stretcher with legs elevated. VSS at O2 sat 99%, HR 66, BP 140/80. Patient reports he had not eaten since previous day at 6pm, given snack bar and 2 oranges. Patient remained in waiting area for 30 minutes and stated he felt recovered when leaving facility.


VAERS ID: 1195084 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Unknown  
Location: Indiana  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Nervousness, Pallor
SMQs:, Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient received the vaccine and was told to stay for 15 minutes for observation. After 5 minutes the mother came with the son stating that he was not feeling well. He looked a bit pale and brought the patient back to the vaccination booth. I alerted management on duty . The mother expressed that the soon was very nervous about getting the shots and tends to be nervous in general when it comes to getting shots. She stated that the doctor had suggested for him to put his head down when he gets that nervous. The son put his head down between his knees and within 1 minute he stated that he felt better. I gave him a cold pack which he put in his neck since he did not want to lay down. I told them to stay a bit longer and observed him for additional 20minutes just to make sure he was doing ok. I stayed with them to make sure that the pt was doing ok and he was alert and just stated he was very nervous about getting the shot. The stayed for at least 35minutes and also management came to make a report of the incident. I felt that the pt was nervous but wanted to report it just in case.


VAERS ID: 1195088 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fall, Head injury
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

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

Write-up: Patient received vaccine, stood up to leave to lobby for observation period, turned back and said he felt light headed, this RN advised that he needed to sit down but before we could find a seat, patient wobbled then fell backwards, striking his head on an upright support.


VAERS ID: 1195090 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Had COVID in Feb 2021, not hospitalized
Preexisting Conditions:
Allergies: Allergic to shrimp
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received vaccination, fainted immediately following injection at 4:20pm. Safely positioned on the floor, vital signs assessed, BP was 77/59, pulse 55, pulse ox 99 on room air at 4:21pm; alert and oriented x4, responsive and vitals reassessed within normal limits at 4:25pm. cold compress and water provided. patient ambulated to observation area, monitored by EMT at 4:30pm. patient observed for 30 minutes, advised to download vSafe for follow guidance post discharge.


VAERS ID: 1195111 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Flushing, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Slight light headed ness, but major flushing and the beginnings of hives. I got myself up and ate 2 Benadryl. Made it home, fell asleep for 3 hours, seems okay now.


VAERS ID: 1195126 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient was vaccinated at clinic at approx 4pm and showed no signs and symptons during required 15 minute observation period. She return to work but began feeling lightheadness, cold sweats. and shortness of breath at 530pm. EMS was contacted at work place and patient was transported to hospital.


VAERS ID: 1195133 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Cold sweat, Disorientation, Electrocardiogram, Feeling abnormal, Feeling hot, Laboratory test, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Erithromycin
Diagnostic Lab Data: pulse, blood pressure, ecg, blood draws (don''t know what labs done).
CDC Split Type:

Write-up: I had shot and sat to be observed at 8:30 am. After about three minutes I felt a wave of adrenaline type feeling wash over me and my heart raced and I felt really out of it/fearful. I sat for a minute hoping it would pass, and it didn''t so I asked for help. EMT gave me pulse check and blood pressure, both were very very high (don''t know what) and irregular so they brought ECG. The ECG was also irregular. I felt disoriented and had waves of heat/blood racing/pulse racing. I was taken by ambulance to Hospital. Within 2.5 hours I was feeling better, not recovered but not as acute. They did another ECG, still irregular and did some blood draws which seemed to satisfy the Dr. that nothing was acute. Once I had returned to a more normal level they released me. Tonight at home I still have a bit of a racy clammy feeling but have felt more stable thus far. It was an awful, scary feeling and it come on in just two or three minutes after shot.


VAERS ID: 1195136 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Transient hypotension


VAERS ID: 1195139 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypotension, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, Aspirin, Dulcolax, Buspar, Colace, Dulera, Lovenox, Pepcid, Lasix, Hydralazine, Atrovent, Insulin (Humulin R), Isosorbide Mononitrate, Metoprolol Succinate, Potassium Chloride, Simvastatin, Spironolactone
Current Illness: COPD, hypertension, emphysema, diabetes mellitus 2, generalized anxiety disorder, constipation
Preexisting Conditions: diastolic heart failure, nonproliferative retinopathy, osteoporosis, white coat syndrome
Allergies: Advair Diskus, Amlodipine Besylate, Amoxicillin Trihydrate, ACE inhibitors, Cephalexin Monohydrate, Pepcid AC, NSAIDs, Clonidine Hydrochloride
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Doctor ordered vaccine for patient prior to discharge. Vaccine RN went to bedside to provide education with EUA form and VAERS. Pt verbalized understanding, questions answered, sitting up in chair. Administered vaccine per protocol in R deltoid per patient preference at 1429 . Observed pt for 15 min. Patient reported feeling well, and documentation completed. RN left the room at 1448 and then went on to administer another vaccine on the same unit, and previous bedside nurse pulled Vaccine RN aside, and said that the patient became hypotensive at 1450. Per Bedside RN BP was 81/42, HR 84. RN assisted patient back to bed and placed in trendelenberg. Doctor notified. 1457- BP 146/55, HR 75, SaO2 93%. MD ordered 250cc bolus of NS. 1550- BP 138/57, HR 79, SaO2 92% on 2L NC. Patient reported feeling better. Pt was cleared for discharge, and sent home.


VAERS ID: 1195188 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)

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

Write-up: Beginning around 3 AM on 4-11-21 experienced extensive joint pain throughout entire body, and beginning at 10 AM and continuing on, experienced significant nausea.


VAERS ID: 1195201 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Janssen Covid 19 EUA the patient felt light headed in Observation after his vaccine. He denied treatment or transport and an AMA was ran through Grossmont ED. Inc# 2021-00021998


VAERS ID: 1195222 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Transient hypotension and bradycardia


VAERS ID: 1195247 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Urticaria


VAERS ID: 1195253 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Takes PRN medication for anxiety.
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin (rash)
Diagnostic Lab Data: 1) V/S WNL. 2) EKG NSR
CDC Split Type:

Write-up: Patient c/o "tightness in chest" denies SOB. Patient stated that drinking water help her feel better. V/S stable obtain EKG NSR patient was release in stable condition by MD onsite.


VAERS ID: 1195289 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hot flush, Pyrexia, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D, B12, Lysine
Current Illness:
Preexisting Conditions: Occasional canker sore
Allergies: Almonds
Diagnostic Lab Data:
CDC Split Type:

Write-up: At night time, felt my face getting hot and felt as if I had a fever. 4 days later, developed itchy rash under the armpits, and sides, lower stomach inner thigh near groin.


VAERS ID: 1195290 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Benadryl, Citrus fruit.
Diagnostic Lab Data: 1) V/S WNR. 2) O2 SAT 98%
CDC Split Type:

Write-up: Nausea, vomit, and headache.


VAERS ID: 1195296 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: 102 fever, chills, cough


VAERS ID: 1195316 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin 50mcg once daily
Current Illness: Hypothyroidism
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: Haven?t seen medical care yet
CDC Split Type:

Write-up: Consistently ringing ears


VAERS ID: 1195353 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Feeling abnormal, Malaise
SMQs:, Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: General feeling of unwell Chills Upset stomach


VAERS ID: 1195356 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Flushing, Hot flush, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: chills, hot flashes, feeling flushed, fatigue, mind fog, pain at injection site, extremely sore muscles


VAERS ID: 1195376 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient claimed started to feel dizzy, sweaty and light-headed after about 5 minutes. After 30 minutes, patient vomitted.


VAERS ID: 1195384 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 25mcg - Gabapentin 600 mg 3x /day - Seroquel 600 mg 4 x / day - Stratera 100 mg / day - Lamictal 200 mg 2x / day - Pantoprazole 40 mg /day - Doxycycline Nono 100 mg / day - Vytorin 10-10 / day Supplements: Hair, nails, skin vita
Current Illness: None
Preexisting Conditions:
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Aches (neck, elbow) Temperature 102. 0 - BP: 120 / 59. 102 Pulse


VAERS ID: 1195416 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Rashes all over different parts of the body causing severe itchiness and some swelling. Randomly appears in places and disappears after two or so hours.


VAERS ID: 1195451 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Nausea, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Felt drowsy and feverish, later nauseated and vomited.


VAERS ID: 1195466 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Immediate post-injection reaction, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)

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

Write-up: Immediately after receiving vaccine, while waiting in observation area, patient started to feel "weak in the knees" and "tingling" in legs. patient admits history of dizziness in the past with blood draws. No prior history of allergies. No history of COVID, Last meal/snack/drink 24 hours prior. Patient was advised to lay supine- also given snacks/water. Symptoms resolved with rest. BP 133/75, Pulse 66.


VAERS ID: 1195476 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Confusional state, Dizziness, Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Seizures (never had before), high fever 102+, dizziness, severe back pain, convulsions and confusion


VAERS ID: 1195477 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / IM

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

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

Write-up: Patient reported dizziness following vaccination while in observation station. Patient was advised to lay supine. Also given water/snack. BP 11:23am: 116/84, Pulse: 92. Last meal/snack/drink: 11 hours prior No history of Allergies Symptoms resolved after hydration/food/rest.


VAERS ID: 1195489 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Hypoaesthesia, Visual impairment
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: While in observation area, patient started to feel dizzy/lightheaded, sweaty/numbness to hands/feet, "static" vision. BP after laying supine: 107/68, Pulse 58, repeat BP 10 minutes later after rest/hydration/snack: 120/83, Pulse 84. last meal/snack/drink: 2.5 hours prior to vaccine- fruit smoothie Prior history of syncope from tooth extraction/flu illness Patient gradually recovered after rest/hydration/food.


VAERS ID: 1195531 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysgeusia, Hemiparesis, Nausea, Parosmia
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, wellbutrin, dicloxacillin, post-natal with lactation support, fish oil
Current Illness: Mastitis
Preexisting Conditions: Endometriosis
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea within minutes after injection, metallic taste and smell within an hour, slight full body muscle weakness and stronger muscle weakness at injection site within a few hours. All symptoms still present 11 hours after injection.


VAERS ID: 1195536 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Dizzy, fainting, nausea


VAERS ID: 1195548 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pain, Tongue discolouration, Tongue erythema
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Tongue whiter than usual with a reddish round patch near back of tongue. A little raw feeling on the reddish patch but not much discomfort. I did not burn my tongue or anything out of ordinary other than shot. I don?t know if it started this evening, but I noticed as I was brushing my teeth before bed. Left arm also still tender at injection site.


VAERS ID: 1195598 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lexapro 10mg daily adderall xr 10mg daily
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up with severe chills and body aches, especially in the lower back region. Progressed into nausea within 30 minutes. Fever fluctuating between 0.5-2 degrees above normal body temp. Nausea and chills subsided after about 2 hours, body aches dulled. Headache and severe fatigue persisted the entire rest of the day.


VAERS ID: 1195618 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: fever and throwing up


VAERS ID: 1195632 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-24
Onset:2021-04-11
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Pleuritic pain, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cetirizine/fosinopril/escitalopram/HCTZ/metoprolol
Current Illness:
Preexisting Conditions:
Allergies: gentamicin
Diagnostic Lab Data: CTA diagnosed right sided PE on 4/12/2021
CDC Split Type:

Write-up: right sided pleuritic chest pain started 04/11/2021.


VAERS ID: 1195636 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chills, Headache, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

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

Write-up: Extreme back pain, shaking, chills, headache


VAERS ID: 1195676 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

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

Write-up: Fever , chills , excessive sweating , body aches , headache , fatigue


VAERS ID: 1195688 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Other       Purchased by: ?
Symptoms: Bradyphrenia, Decreased appetite, Dizziness, Fatigue, Feeling abnormal, Headache, Paraesthesia, Pyrexia, Rhinorrhoea, Vertigo
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tuberculosis, yellow fever (not certain)
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: For at least 20 hours: Fatigue, woozy/clouded head, slow to process thoughts, fever ranging from 99.5 F - 101 F, lack of appetite Frequently during the above 20 hours: "tingly" nerves across body, "swimming" sensation when turning head with delay in focusing, headache For hours 16-18 after vaccination: runny nose


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