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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 61 out of 1,889

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VAERS ID: 1195693 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
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 206A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Myalgia, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, fatigue, muscle soreness


VAERS ID: 1195699 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
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: Pharmacy       Purchased by: ?
Symptoms: Chills, Gait disturbance, Pain, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Allergic to codeine, fish, wasps, chemicals
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8.5 hours after vaccine, experienced convulsive shaking, teeth chattering, trouble walking/ handling objects. Severe pain all over body, particularly in spine and hips.. Lasted 1 hour. Followed by fever that lasted 9 hours.


VAERS ID: 1195737 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
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: 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: None
Current Illness: None
Preexisting Conditions: Unaware of any
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever if 104.2 the morning of April 12. Full body aches and sharp pains.


VAERS ID: 1195757 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Ohio  
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 - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Cerebral disorder, Chills, Feeling hot, Headache, Myalgia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Arthritis (broad), Tendinopathies and ligament 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: Hypertension
Preexisting Conditions: Hypertension
Allergies: Augmentin, Codeine, Vicodin, MRI Contrast Dye
Diagnostic Lab Data: None
CDC Split Type: JSN 042A21A

Write-up: 0835 Injection, 0930 Blurry Vision driving home / 150-200 feet before I could read road signs. 1000 hours chicken noodle vegetable soup. Lie down / chills them "hot" off and on PM / rest of the day / no discernible fever by forehead touch / mild headache. 0700 4-11-2021 no headache, but brain "felt sore"; best I can describe it. 1030 hours 1000mg Tylenol, repeat at 1900 hours / repeat at 0400 hours 4-12-2021. 0800 hours 4-12-2021 "brain soreness" mostly gone. Many bowls of chicken noodle vegetable soup 4-10 / 11- 2021. Muscle / joint pain 4-10 / 11 / 2021 but I expected that. Some joints surprised me. Blurry Vision / brain soreness was a total surprise.


VAERS ID: 1195769 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Pennsylvania  
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 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Petechiae, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: small red dots on inside of right elbow-Mild, Additional Details: Patient has not sought medical attention at this time, but has a small red petichial rash on the inside of his right elbow. He thinks this may be signs of capillary leakage that have been reported with the vaccine. I advised he seek medical attention if required. No injection site issues or reactions in left arm.


VAERS ID: 1195774 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Delaware  
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 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), 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: Systemic: Fainting / Unresponsive-Severe, Additional Details: IMMUNIZERS WITNESSED PATIENT FALL OUT OF HER CHAIR AND LOSE CONSCIOUSNESS. THEY CALLED 911 AND MONITORED HER. LETTING HER STAY LAYING THEN HELP UP SLOWLY TO SEATED POSITION. TRIED TO MONITOR BP, BUT AMBULANCE ARRIVED BEFORE THEY COULD GET CUFF ON. PATIENT DECLINED GOING TO HOSPITAL. FOLLOWED UP VIA PHONE CALL.


VAERS ID: 1195778 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
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 202A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 of 102.8 Body aches Headache


VAERS ID: 1195779 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Florida  
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 AR / 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? 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: Systemic: Dizziness / Lightheadness-Mild


VAERS ID: 1195780 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Indiana  
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 042A21A / 1 RA / -

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

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

Write-up: Slight headache, nausea, achy. Treated with Tylenol.


VAERS ID: 1195785 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Illinois  
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 / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1195792 (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: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

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


VAERS ID: 1195795 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
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 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Difficulty breathing -Mild, Systemic: Nausea-Medium


VAERS ID: 1195822 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Indiana  
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 - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache, Injection site pain
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Headache, pain where the vaccine was inoculated, tiredness/fatigue, pain in the back


VAERS ID: 1195832 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Minnesota  
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 203A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site pain, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: COVID-19 Vaccine EUA About 12 hours after injection of vaccine I started to get a head ache; and about 16 hours after injection I started to get full body aches (mostly muscle) especially at injection site. Body aches lasted a full 24 hours after they started,


VAERS ID: 1195863 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: About an hour after the shot, I began hearing a faint ringing in my right ear. It is very low volume, but it is there. It now occurs about every 2 hours and the ringing lasts for only about 15 seconds before going away again. This does not happen in my left ear. The tone of the ringing is equivalent to a C4 on a piano. It is not harsh, and sounds like a synthesizer tone.


VAERS ID: 1195869 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
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: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (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: Zyrtec, Nortriptyline Lo-Dose Aspirin, Cascara Sagrada, Mega EFA+D3, Glucosamine, Chondroitin & MSM, Reishi, CoQ10, Oregano Oil, Resveratrol, Calcium, Magnesium & D3.
Current Illness: n/a
Preexisting Conditions: Meniere''s, Migraines
Allergies: Penicillin -Causes breathing problems, dizziness, low blood pressure, Sulfa -Causes breathing problems, Codeine -Causes breathing problems, Mycin Drugs (macrolides) Causes breathing problems with mouth and tongue swelling. History of Anaphylaxis from WALNUTS (Ambulance/ER required at least a dozen times)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lower lip and tongue 15 minutes after shot. Benadryl every 12 hours is managing the situation


VAERS ID: 1195878 (history)  
Form: Version 2.0  
Age: 38.0  
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 - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Chills, fever, joint pain, headache, nauseau, diarrahea all started about 7 hours after the shot. Lasted for about 9 hours.


VAERS ID: 1195892 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
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 / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Hot flush, Lethargy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 8 hours after vaccination, became very lethargic, weak and got a fever of 103.2 degrees Fahrenheit. Was getting the chills followed by hot flashes. Woke up next morning (today) still with a 100.7 degrees Fahrenheit fever. Took Tylenol when symptoms started to occur.


VAERS ID: 1195896 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Hyperhidrosis, Paraesthesia, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID-19 complications
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted in pharmacist''s arms, was lowered to ground and came back to pretty quickly, called 911 to come and make sure she was ok, could not indicate her surroundings for a bit, shaking, sweating, tingling in extremeties


VAERS ID: 1195907 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
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 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Pain, 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: spironolactone, fish oil, multivitamin, zinc, vitex, probiotic, ACV
Current Illness: none
Preexisting Conditions: chronic migraine
Allergies: topomax
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: headache, fever, chills, body ache, stomach muscle soreness (I am quite fit - have defined stomach muscles... but it felt like I was going to give myself a hernia sitting up in bed)


VAERS ID: 1195919 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lorazepam .25 mg, vitamin D3,
Current Illness: no
Preexisting Conditions: none
Allergies: sulfa
Diagnostic Lab Data: no
CDC Split Type:

Write-up: pt says she got really tired about 4:30 in the afternoon after taking the vax. She went to bed. Her fever went up to 101. She took Tylenol. It came down to 100 but went back up to 102.4 so then took ibuprofen. It went down to 101. She took her lorazepam to sleep. Her fever broke during the night. Today she has fatigue and a sore left arm.


VAERS ID: 1195923 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nausea, Paraesthesia, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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? 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 was feeling nauseated, tired, shaking, having tingling in extremities, kept trying to close their eyes. Gave some orange juice and crackers and was able to keep them awake.


VAERS ID: 1195955 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
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 / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Culture, Fatigue, Freezing phenomenon, Headache, Pain, Pyrexia, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Guillain-Barre 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levi thyroxine and Zyrtec
Current Illness: None
Preexisting Conditions: No thyroid, calcium disorder
Allergies: Vancomycin, seasonal allergies, latex
Diagnostic Lab Data: Went to ER got Bloodwork, cultures, urinalysis, fluids zofran snd toradol
CDC Split Type:

Write-up: Got the shot at 12pm by 2pm felt weak, achy, started to get a fever of 99.9, extremely tired. Took Tylenol by 1:30-? was throwing up and fever continued to spike to 102.4 and vomiting started. Pounding headache. Could not get fever to break and freezing.


VAERS ID: 1195963 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Florida  
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 1808609 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Headache, Myalgia, Nausea, Night sweats, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Dizzyness, high-grade fever, breathing issues, muscle and joint pain, chills, night sweats, nausea. No treatment other than trying to sleep and hope it goes away in the morning. This morning I feel very dizzy, still have a headache, and still have a fever.


VAERS ID: 1195972 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Massachusetts  
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 1808980 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Diarrhoea, Dizziness, Headache, Nausea, Pain, Pain in extremity, Polymenorrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Pine nuts, walnuts, cashews, dill, strawberries, egg, gluten, food dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, nausea, vomiting, diarrhea, arm pain, body aches, joint pain, headache, my period which is otherwise regular started two weeks early the day after the vaccine


VAERS ID: 1195990 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Vermont  
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 - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Malaise, Pruritus, Pyrexia, Somnolence
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Setraline, testosterone
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: The evening after my vaccination shot, I started to feel groggy and unwell. I then started to develop a fever. This morning on 4/12/21, I woke up to my right hand itching and burning. Within a half hour I started to experience the same burning and itching sensation on my hands.


VAERS ID: 1195993 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

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

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

Write-up: Headache, body aches, fever, chills, tired Rest, ibuprofen, lots of water Feeling better just some lingering body aches.


VAERS ID: 1196015 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
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 042A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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: Birth control pill
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Felt light headed at 8pm. I laid down and then started to get terrible chills. Around 10pm the chills turned to muscle aches all over and a terrible headache. Had a fever of 99.9 at 3am. The headache and mild muscle aches have continued into the next day as of 9:30am. The site of injection has been sore to the touch ever since I got the shot as well.


VAERS ID: 1196034 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-11
Onset:2021-04-11
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chills, Cough, Pneumonia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ventolin HFA, aspirin, atorvastatin, buspirone, clonazepam, clopidogrel, famotidine, miralax, sertraline
Current Illness: None known
Preexisting Conditions: Hyperlipidemia, anxiety, overweight, hypertension, dementia, history of cerebral vascular accident
Allergies: Codeine (nausea)
Diagnostic Lab Data: COVID-19 positive on 4/11/21.
CDC Split Type:

Write-up: Presented to urgent care on 4/10/21 with fever, chills, weakness, and cough. Was tested for COVID-19 and diagnosed with pneumonia. Patient then presented to ED on 4/11/21 with the same symptoms and was admitted to hospital for further care.


VAERS ID: 1196039 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Massachusetts  
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 043A21A / 1 LA / IM

Administered by: Private       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: A 17 year old patient was given the Janssen vaccine instead of Pfizer. Janssen is not approved for under 18 years of age. The patient was monitored for 30 minutes after vaccination with no adverse effect. Patient''s legal guardian was present and aware of the situation.


VAERS ID: 1196053 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Dizziness, Fatigue, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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: Levothyroxine 0.25mg, Lexapro 20mg, Montelukast
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm one hour after receiving immunization, around 5:00pm dizziness, tired, nausea. 9:00pm : 101.2 fever, body aches, fever subsided with 600mg Motrin. 4/12: 8am: normal temperature, body aches, tired.


VAERS ID: 1196074 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
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: Other       Purchased by: ?
Symptoms: Dizziness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, blisovi fe (birth control), phentermine, multi vitamin, psyllium seed husk, feverfew, vit d3, CoQ10, Cranberry, Lutein & Zeaxanthin.
Current Illness: None
Preexisting Conditions: Vertigo, osteo arthritis,
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness. Slight fever


VAERS ID: 1196117 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
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: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Hypoaesthesia, Nasal congestion, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg
Current Illness:
Preexisting Conditions: Asthma
Allergies: Inhaled steroid allergy - Advair
Diagnostic Lab Data:
CDC Split Type:

Write-up: Neck numbness - 90 minutes after shot, lasted 30 minutes Dizziness - 120 minutes after shot, lasted 40 minutes Chills - 120 minutes after shot, lasted 10 minutes Body aches - 4 hours after shot, lasted 16 hours Fever - 12 hours after shot, lasted 1 hour Headache - 19 ours after shot, lasted 20 minutes Stuffy head - 20 hours after shot, lasted 1 hour


VAERS ID: 1196155 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kentucky  
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 207A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Nausea, Visual impairment
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Osteonecrosis (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: Zytec
Current Illness:
Preexisting Conditions: Migraines, infertility
Allergies: Bee venom and doxycyline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe bone pain, nausea, vision changes


VAERS ID: 1196161 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
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 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Nausea, 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: High Temp 101, signs of nausea/vomiting


VAERS ID: 1196169 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
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: Erythema, Rash, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Severe rash (bright red welts) spreading around shoulder area (top of arm to neck) Left side, where vaccine was administered.


VAERS ID: 1196178 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Colorado  
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 205A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Gaze palsy, Headache, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Did not see anyone for reaction, didn''t know if I needed to since they said you could feel sick.
CDC Split Type:

Write-up: Shot at 1:50pm Saturday. Woke with headache at 2:45am Sunday. By 5:00am Sunday had bad stomach pain and fever of 100.9F. Headache varied, got worse, got better, got worse, etc. Bad stomach pain lasted straight through until about 1:00am Monday. It''s now 8am Monday, a little bit of stomach pain but far less than what it was.


VAERS ID: 1196179 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
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 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant 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: na
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data:
CDC Split Type:

Write-up: High Temp 101, signs of nausea/vomiting


VAERS ID: 1196195 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Florida  
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 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chills, Eye pain, Fatigue, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Glaucoma (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: 1 pill of acetaminophen was taken around 5 PM for arm and lower back soreness. Shivering, chills, radiating pain behind eyes started around 11 PM. Patient was kept warm and rested. May have developed fever throughout the night. Was given acetaminophen around 3 AM for headache. Adverse symptoms had ceased. Patient is now fatigued.


VAERS ID: 1196212 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
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 / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Palpitations, Pyrexia, Retching
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: prebiotics, probiotics, multivitamin without iron, vits D3 and B12, HCl Betaine, Magnesium Glycinate
Current Illness: None
Preexisting Conditions: Constipation
Allergies: wheat, gluten, dairy, artichokes, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting at 11 hours post injection: severe headache, nausea/dry heaves, fever, chills, heart palpitations for 18 hours; lingering headache for 8 more hours


VAERS ID: 1196227 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
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 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Nausea, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma GERD EE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache Vomiting Unable to hold food or water Fever Chills Nausea


VAERS ID: 1196273 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-30
Onset:2021-04-11
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray normal, Cough, Fatigue, Hypokalaemia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Infective pneumonia (broad), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, atorvastatin, cholecalciferol, cyanocobalamin, fluoxetine, fluticasone, gabapentin, hydrochlorothiazide, levetiracetam, omeprazole, zonisamide
Current Illness:
Preexisting Conditions: seizure disorder, peripheral neuropathy, HTN, gait instability, frequent falls, dyslipidemia, diverticulosis, depression, asthma
Allergies: ceftriaxone, paroxetine, rofecoxib, celecoxib, diazepam, famotidine, lamotrigine
Diagnostic Lab Data: Clear chest xray - 4-11-2021 Positive SARS-CoV-2 PCR test via NP
CDC Split Type:

Write-up: Pt received first dose of the Pfizer COVID 19 vaccine on 3/30/2021. She presented to the ED on 4/11/2021 with fatigue, cough, hypokalemia, and generalized weakness. She was admitted to an inpatient unit and tested for COVID-19 which came back positive. Anticipated discharge is today, 4/12/2021


VAERS ID: 1196309 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Connecticut  
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 / SYR

Administered by: Public       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Nausea, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3, vitamin k
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Negative covid test 4/12
CDC Split Type:

Write-up: Fatigue, slight nausea, headache, lack of appetite


VAERS ID: 1196372 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
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 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Dysgeusia, Headache, Pain, Palpitations, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (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: Previous tooth infection
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Metallic taste in mouth within 3 minutes of Injection lasting overnight,104 degree temperature for 7 hours, severe chills, severe body aches, racing heartbeat , unable to sleep. I currently have low grade fever, body aches, headache, moderate low back pain Me


VAERS ID: 1196394 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
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 / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Benicar, Multi-Vitamin
Current Illness: No current or recent illnesses.
Preexisting Conditions: Underlying Conditions- Diabetes Type 2 and High Blood Pressure
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness and small swelling under the injection site. Little warmth and tenderness to touch. Occasional itching. No treatment sought as this is an expected side-effect and is not bothersome, overly painful or too swollen.


VAERS ID: 1196406 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
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 201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Aphasia, Confusional state, Dysarthria
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), 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: GABAPentin
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Confusion. Memory loss. Difficult time with word retrieval. Difficulty articulating


VAERS ID: 1196424 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Illinois  
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 042A2IA / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Nausea, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Drospirenone and Ethinyl Estradiol 3 mg/.02 mg Fluoxetine 10 Mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: nausea, vomiting, migraine, fever (101.2 degrees), treated with advil/tylenol


VAERS ID: 1196462 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Massachusetts  
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 043A21A / N/A RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Hypersomnia, Nausea
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: I was fine Saturday after the shot. Sunday I was completely enervated. I had a bad headache and zero energy and a little bit of nausea. I started feeling better around 6:00 pm, but went to bed at 8:30 pm and slept 9 hours (which is very long for me).


VAERS ID: 1196485 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
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 201A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Eye movement disorder, Fall, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Ocular motility disorders (narrow), 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt. turning in vaccine paper work for monitoring. Pt kneeled on one knee. Nurse went to side. Pt. feel back, eyes rolled back not responding, snorted. Rolled on left side then come back, became aware of person, place and time. EMT reported and observer the patient for 30 more minutes. Vitals: BP 131/72, RR: 20, HR 71, OxSat 100%.


VAERS ID: 1196535 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Ohio  
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 1808609 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Zoloft, Zyrtec, Claritin
Current Illness:
Preexisting Conditions: allergies, anxiety
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt diaphoretic c/o dizziness. Pt. placed in a sitting position on the floor. Fireman called to assist with patient. Fireman placed pt in a Trendelenburg position. Pt stated that her dizziness was immediately relived. After another full minute, pt stated she was no longer diaphoretic. Pt placed back in a sitting position in chair by fireman. Pt. monitored for entire 30 min. 1059 pt released to go home. States that she''s feeling well.


VAERS ID: 1196544 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Indiana  
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 1808609 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dyspnoea, Pain, Sleep disorder
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: Trileptal, Topamax, Cymbalta, Nexium, Nadolol, Abilify, Claritin, CBD Coffee
Current Illness:
Preexisting Conditions: Traumatic brain injury, post-traumatic seizure disorder, depression, anxiety, bipolar disorder, insomnia, chronic migraines, chronic neck aches
Allergies: Penicillin allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the first night after receiving the shot I woke up 1 hour after falling asleep with extreme chills. I had to get up and did not sleep again that night. I also experienced a slight difficulty in taking deep breaths. All of my muscles were sore and continue to be so 36 hours later, though that is improving. I did get normal sleep the following night.


VAERS ID: 1196564 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Ohio  
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 201A21A / UNK LA / IM

Administered by: Other       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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt stated she felt dizzy. B/P normal range, pulse rate lowered to 47. Pt was monitored until pulse reate increased to 65. Pt. was discharged home.


VAERS ID: 1196575 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
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 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blindness, Deafness, Hyperhidrosis, Nausea, Pain in extremity, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Tendinopathies and ligament 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: Gardasil, age 22 approx
Other Medications: Unknown
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: Vinegar, avocado, papaya, banana, tuna
Diagnostic Lab Data: BP 86/52
CDC Split Type:

Write-up: Immediate nausea, left arm pain, tingling in left arm, sweating, loss of vision, loss of hearing, stomach pain, tingling in fingers after approx. 10 minutes.


VAERS ID: 1196585 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Indiana  
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: Body temperature fluctuation, Fatigue, Headache, Immediate post-injection reaction, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

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

Write-up: Injection site pain immediately. Overnight - body temperature swings, headache, fatigue


VAERS ID: 1196604 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Ohio  
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 201A21A / UNK UN / IM

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

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

Write-up: Pt. passed out, hit floor 5 minutes after vaccine. Vs 130/78, HR 68, OxSat. 98%. Pt on floor, legs elevated, water offered. Pt is now able to sit down in chair un-assisted.


VAERS ID: 1196616 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Head injury, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (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:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vasovagal / syncope episode with subsequent fall to the ground, striking head; taken to the Emergency Department, stated prior to syncopal episode felt lightheaded, sweaty, clammy. Patient discharged to home within 3 hours of ED admission.


VAERS ID: 1196627 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Indiana  
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 042A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Cold sweat, Headache, Hyperhidrosis, Migraine, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament 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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Woke up 8 am 4/11 headache and body achs. When I got moving my headach turned more migraine body achs were every joint/ muscle hurt, once I sat down after morning routines I found myself with the dead sweats. I was shivering and clammy sweating continuously. Symptoms subsided about 5pm


VAERS ID: 1196643 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
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 - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Fatigue, Headache, Pain
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Dehydration (narrow)

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

Write-up: My wife and I both took the JJ at the sametime/same place. Both wife and I felt sting during injection. Next morning, the wife and I were tired. Body aches and headache. It''s almost 48 hours since vaccination and we both still feel tired and have mild headaches. Was advised these are all normal side effects, but should be reported anyway. Side note: Wife had severe dehydration 24 hours after. I believe this was the only not listed side effect. No treatments, just waiting it out. Reactions seem to lesson each day.


VAERS ID: 1196646 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Ohio  
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 201A21A / UNK RA / IM

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

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

Write-up: Pt. passed out, hit floor 5 minutes after vaccine. Vs 130/78, HR 68, OxSat. 98%. Pt on floor, legs elevated, water offered. Pt is now able to sit down in chair un assisted.


VAERS ID: 1196658 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
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 - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Keppra, Vitamin D, Levothyroxine, Multi vitamin
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Tree nuts, coconut and Topamax
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness and swelling on the arm but approximately 2 inches from injection site, headache, fever and chills


VAERS ID: 1196672 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Ohio  
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 201A21A / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Seizure
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: After sitting in chair to be monitored pt felt dizzy and had seizure for 15 min. VS right after seizure@1113: BP 138/94, HR 42, OxSat97%. Rechecked vitals after sitting back up for 20 min: Blood sugar 108, OxSat: 99%, HR 56, BP 117/75. This was the first seizure for the patient. He does not want to go to ER. Pt was monitored longer. EMS reported he could be released to go home. Parents were instructed to notify MD and to monitor pt status if any seizure like activity call 911. This patient frequently passes out with shots.


VAERS ID: 1196681 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
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 - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Oropharyngeal pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D - Iron - Zoloft - Hydrocodone - Fentanyl
Current Illness: Right Lung partial collapse Acid reflux
Preexisting Conditions: Acid reflux Chronic diarrhea Malabsorption
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bad headache chills. Body aches and all over muscle soreness and sore throat


VAERS ID: 1196698 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Computerised tomogram, Dizziness, Fall, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (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:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: CT head (04/11/21)
CDC Split Type:

Write-up: Vasovagal / syncope with subsequent fall to the ground, striking head; transferred to Emergency Department - stated lightheaded, dizziness, clammy prior to syncope and fall. Patient discharged to home in stable condition from facility within 3 hours.


VAERS ID: 1196715 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Ohio  
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 1808609 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Allergy to vaccine
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Moderna
Other Medications: None
Current Illness:
Preexisting Conditions: none verbalized
Allergies: Several Allergies, Moderna vaccine
Diagnostic Lab Data:
CDC Split Type: MD ordered Janssen vaccin

Write-up: Pt. with history of allergic reaction to Moderna vaccine. PCP ordered administration of JnJ vaccine in presence of paramedics. Vaccination given. Per EMS, epinephrine (patient''s owns epipen) was administered @ 1059AM prior to transporting to hospital.


VAERS ID: 1196732 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Washington  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Muscle twitching, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Setlakin 0.15mg, ibuprofen 200mg
Current Illness: No
Preexisting Conditions: Migraine
Allergies: Penicillin, mint (menthol)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Intense muscle and joint pain, nausea, uncontrollable twitching


VAERS ID: 1196735 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Pennsylvania  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Nausea, Tachycardia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: c/o dizziness, nausea and shaking. BP elevated and tachycardic. Blood glucose 110. Started to resolve and then felt worse again. Transported by POV with husband driving to Er. Refused 911.


VAERS ID: 1196742 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Indiana  
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 043A21A / 1 LA / SYR

Administered by: Other       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: Lisinopril 20MG Metformin HCL ER 500MG,. Atorvastatin Calcium USP 10MG EACH IS 1 PER DAY
Current Illness:
Preexisting Conditions: Sleep apnea
Allergies: Bee Stings
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Effects started approximately 24 hours after injection with a mild headache. Within 2 hours of the onset of the headache queasiness and vomiting occurred.


VAERS ID: 1196765 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
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 201A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dysphagia, Hypoaesthesia oral
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)

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: Pt has a list of medications to treat her HTN
Current Illness: None
Preexisting Conditions: RA, HTN, Hypoparathyroidism, CHF, Migraines
Allergies: Allergies to medications: HCTZ, methacarbamol, methrotexate,
Diagnostic Lab Data: None
CDC Split Type:

Write-up: C/O numbness lips and tongue. Cleared to leave @ 1215 Pt denies SOB or swallowing difficulty. Discharged at 1232.


VAERS ID: 1196769 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Delaware  
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 202A21A / 1 RA / IM

Administered by: Public       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, body aches


VAERS ID: 1196775 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: D.C.  
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 / SYR

Administered by: Public       Purchased by: ?
Symptoms: Headache, Injection site pain, Muscle fatigue, Nausea, Ocular discomfort, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: 15mg Lexapro daily Vitamin D + Calcium Magnesium Vitamin B2 Vitamin B12
Current Illness: I was on my period at the time of vaccination, maybe that could effect severity of side effects?
Preexisting Conditions: Inappropriate sinus tachycardia Anxiety
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Painful injection but fine for the majority of the day. Started feeling muscle fatigue around 4pm, with upper body aches, stinging eyes, and nausea by 6pm. Fever of 102, and progression to full body aches and headache by 8pm in addition to the aforementioned symptoms that continued throughout the night. Fever lowered to 99 and only minor body aches by mid morning on the 12th. Headache continued throughout the day with low grade fever. I predict that I will feel 100% better within 48 hours.


VAERS ID: 1196826 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Blindness, Cold sweat, Computerised tomogram head, Dizziness, Head injury, Laboratory test, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: remote history of seizure, previous history of vagal episode when donating blood, vagal episode while having labs drawn during current ED admission for vagal episode s/p COVID vaccination.
Allergies: NKDA
Diagnostic Lab Data: CT head, routine labs.
CDC Split Type:

Write-up: vasovagal episode / syncope with subsequent fall to ground, striking head. lightheaded, clammy, loss of vision prior to episode. Brought to Emergency Department, discharged to home in stable condition within 5 hours.


VAERS ID: 1196834 (history)  
Form: Version 2.0  
Age: 35.0  
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 1808982 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, fish oil, iron supplement, Zoloft, valacyclovir, birth control pill (norg-ee), cephalexin, ibuprofen
Current Illness: I?m being treated for anxiety and depression; the valacyclovir is treatment for a scar on my right cornea I got from a shingles infection years ago, and I recently had dental work?the antibiotic is a precaution after that. I?m otherwise healthy.
Preexisting Conditions: See item 11.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue that increased, muscle and body aches, starting at the vaccine site then radiating through my shoulder and back, fever, chills, and severe body aches around 11 hours after receiving the vaccine. I took ibuprofen, which didn?t have much effect, followed by Tylenol 3, which relieved the pain enough that I fell asleep. By morning (7am) the fever had dispersed along with the other symptoms apart from soreness around the injection site.


VAERS ID: 1196880 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: North Carolina  
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 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain
SMQs:

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

Write-up: Full body aches Headache Chills Fatigue


VAERS ID: 1196907 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
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 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Myalgia, 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: Flu shots
Other Medications:
Current Illness: No
Preexisting Conditions: C.R.E.S.T. Schleroderma autoimmune disease
Allergies: Latex, penicillin, nsaids
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, headache, muscular pain


VAERS ID: 1196911 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-04
Onset:2021-04-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017821A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Breath sounds abnormal, Chest X-ray abnormal, Chills, Computerised tomogram thorax abnormal, Confusional state, Continuous positive airway pressure, Fall, Pneumonia aspiration, Pyrexia, Regurgitation, Speech disorder, Swollen tongue, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin, bumetanide, amlopdpine, trulicity, lisinopril, sotalol and carvedilol
Current Illness:
Preexisting Conditions: kidney disease, diabetes, heart failure
Allergies: N/A
Diagnostic Lab Data: CT scan 04/05/21; chest xray 04/07/21
CDC Split Type:

Write-up: started with chills and slight fever. Went to bed; however, wears a CPAP. At around 2am spouse awoke and heard strange gurgling sounds. Husband sleeps on back due to CPAP. Upon turning on light discovered he had thrown up and had regurgitated the vomit into his mask and back down throat. Very high fever, body hot all over, in state of confusion and slid off bed; tongue swollen and hard to understand him. Called paramedics and they took him to hospital immediately saying "he was in bad shape". Admitted to Hospital at around 6am after being in emergency room and treated with antibiotics and steroid. Stayed in hospital 4 days. Diagnosis: aspirated pneumonia. Home but with health care.


VAERS ID: 1196956 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Massachusetts  
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 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: he reports same sxs with previous vaccines and blood draws
Other Medications: None
Current Illness: None
Preexisting Conditions: Anxiety and depression
Allergies: None
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: He received vaccine and stood to go to monitoring area, noted by vaccinator to lower self to ground. Complained of dizziness, nausea and diaphoresis. No LOC. Did not eat prior to coming to clinic. Provided with juice and crackers. VS stable throughout, He declined ambulance or call to 911. observed for 30 minutes in medical triage area and then d/c to home via friend Advised patient to follow up with PCP


VAERS ID: 1196992 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
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 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Headache
SMQs:, Anaphylactic reaction (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: Multiple allergies
Allergies: milk, silicone, augmentin, caffeine, corticosteroid, reglan
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient received vaccine and escorted to monitoring area . Developed chest tightness and headache several minutes after administration. she reported multiple allergies, took own Claritin. VS stable, airway patent, no erythema or edema. speaking clearly. 911 called, she declined transport. Watched for 30 minutes and went to ER by private car


VAERS ID: 1197000 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Wisconsin  
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 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Apple Cider Vinegar Gel Tabs, Probiotic/Fiber Powder (OTC), no prescription medications
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Nausea and Dizziness


VAERS ID: 1197017 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Maryland  
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 #202A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Chills, Hyperhidrosis, Influenza like illness, Pain of skin, Psychotic disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), 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:
Other Medications: Vyvanse
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Progressively worse flu-like symptoms beginning approximately 6 hours after injection (~915pm): elevated temperature, psychosis, shivering/shakes, skin-pain, breaking to a sweat by around 5:30am. Treated with 1000mg acetaminophen at 11pm, 600mg ibuprofen at 3am, 1000mg acetaminophen at 5:30am, and 1000mg acetaminophen at noon the next day (20 hrs after injection). Intensity of symptoms gradually subsiding and no plans for additional medication if current trajectory continues.


VAERS ID: 1197028 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
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 043A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient fainted immediately after receiving the vaccine


VAERS ID: 1197046 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: South Carolina  
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 206A21A / 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient representative called pharmacy 4/12/21 stating husband, fainted while at dinner about 5 hours after receiving vaccination on 4/11/21. 911 was called and patient was cleared by EMS at home.


VAERS ID: 1197081 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
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 - / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2020 flu vaccine
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: my right armpit is swollen to about the size of a tennis ball


VAERS ID: 1197092 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Blood glucose, Dizziness, Feeling jittery, Hypotension, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: None
Preexisting Conditions: Self reported anxiety, near syncope and syncope with medical procedures, especially needles.
Allergies: No known allergies reported
Diagnostic Lab Data: Finger stick glucose Rhythm strip, NSR
CDC Split Type:

Write-up: Patient with self-reported history of anxiety, syncope and near syncope with medical procedures/needles. Complained of feeling anxious, light-headed, jittery after vaccination. Became pale, placed in a supine position, provided oral fluids, including fluids with sugar, VS stable, hypotensive to 77/57, pulse ox 99%, blood glucose 185, NSR on monitor reported by EMT on site. Husband called, patient declined EMS transport, was able to ambulate with supervision to husband''s car, husband transport to local ER in private vehicle. Follow up with patient <24 hrs post vaccination: patient reported feeling better. Admitted she was anxious about receiving vaccination since appointment was made one week ago.


VAERS ID: 1197103 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Indiana  
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 043A21A / 1 LA / IM

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

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

Write-up: Fever of 102.8, chills, body aches, massive headache, very tired


VAERS ID: 1197173 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Indiana  
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 - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot - anaphylactic reaction
Other Medications: Meloxicam Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: Flu shot Doxycycline Phenergan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme body aches Cold chills Severe headache Fever


VAERS ID: 1197215 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Indiana  
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 042A27A / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Feeling abnormal, Muscle tightness, Restless legs syndrome, Sleep disorder
SMQs:, Dementia (broad), Dystonia (broad), Guillain-Barre 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: no
Current Illness: no
Preexisting Conditions: (possibly chronic lyme''s disease)
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: - general sense of feeling weaker than normal. - feeling of tense and restless muscles (especially legs), a sense that my body was struggling. - inability to sleep. That lasted about 30 hours. I realize this is probably a mild symptom, and probably a normal reaction. But you might need to know that.


VAERS ID: 1197224 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
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 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Kidney donor. Restless legs syndrome.
Allergies: none
Diagnostic Lab Data: Had Covid 1/21/2021
CDC Split Type:

Write-up: Severe headache, body aches and exhaustion.


VAERS ID: 1197232 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Delaware  
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 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Headache, Muscle spasms, Nausea, Pain, Pyrexia, Thirst, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 100Mg, Nexium 20Mg, Zyrtec 10 Mg, Flonase
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills with violent shaking for an hour, then regular chills, fever on and off for 11 hours, headache, shortness of breathe a few times (each about 10 minute episodes), extremely thirsty, nausea, dizzy, body pain & cramps


VAERS ID: 1197283 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-04-05
Onset:2021-04-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

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

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

Write-up: pruritic rash


VAERS ID: 1197316 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
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 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? 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 was 17 at the time of administration, recommended is 18 years of age. Her father states she has had no adverse reactions or symptoms.


VAERS ID: 1197336 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Georgia  
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 - / -

Administered by: Public       Purchased by: ?
Symptoms: Headache, Hyperhidrosis, Nausea, Palpitations, Paraesthesia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Toprol, Nexium, Tamoxifen, Effexor, Ozempic, Advil, Tylenol
Current Illness: None
Preexisting Conditions: PCOS
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever 100.8, Pouring sweat all night long--range April 11, 2021 approx 10pm through April12 through 10 am. Fever 99.8, Tingling Zaps electrial impulses between temples of forehead from 3 am on 4/12/2021 continues still at 2:01 pm. Headache Contines from 4/10/2021 to present time. Nausea, all day 04/11/2021 all day long Heart Palpitations, 04/11/2021--3 pm to 5 pm & again 9 pm to 11 pm and continued again 04/12/2021 7 am to 11 am


VAERS ID: 1197344 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Virginia  
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 1808980 / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Headache, Influenza like illness, Pain
SMQs:

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

Write-up: Extreme flu-like symptoms. Severe and debilitating headache and body aches.


VAERS ID: 1197346 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-02
Onset:2021-04-11
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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: Multivitamin, Milk Thistle, Benadryl as needed
Current Illness: None
Preexisting Conditions: None
Allergies: Ciprofloxacin caused anaphylaxis
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hives starting 11 April; resolved temporarily with a single dose of benadryl; then recurred the following day.


VAERS ID: 1197357 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
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 / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Dysmenorrhoea, Fatigue, Hot flush, Injection site erythema, Injection site reaction, Urticaria, Vaginal haemorrhage
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Hot flashes without fever, tiredness, redness and welting at injection site, abdominal cramping, vaginal spotting, menstrual cramping


VAERS ID: 1197643 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Missouri  
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 (MODERNA)) / MODERNA 008B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Electrocardiogram abnormal, Fibrin D dimer increased, Heart rate increased, Palpitations, Sinus tachycardia
SMQs:, Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin C (1,000mg), Vitamin D, Junel, Azelastine, Melatonin, Advil PM, Clairinex, Diltiazem, Magnesium
Current Illness: None
Preexisting Conditions: Inappropriate Sinus Tachycardia, airborne allergies
Allergies: Vicodin (vomiting)
Diagnostic Lab Data: D-Dimer 1,439 ng/mL FEU CT scan showed no clots ECG 12-Lead Vent Rate: 129 bpm RR Interval: 464 msec PR Interval: 140 msec QRS Duration: 78 msec QT Interval: 334 msec QTC Interval: 410 msec P-R-T Axis: 51 - 81 - -17 degrees SINUS TACHYCARDIA NONSPECIFIC ST /T/ T-WAVE ABNORMALITY ABNORMAL ECG
CDC Split Type:

Write-up: 12 hours after vaccine administered experienced heart palpitations ranging from 140-160bpm at about 1am Sunday Morning. At 4pm Sunday I was admitted to the emergency room where I was given diltiazem in an IV which did not bring my heart rate down. I was then given another heart medication which brought my heart rate down but I had to stay overnight.


VAERS ID: 1197646 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-07
Onset:2021-04-11
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Alcohol withdrawal syndrome, COVID-19, Chest X-ray abnormal, Hypoxia, Lung infiltration, Lung opacity, Pleuritic pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ZYRTEX 10MG DAILY, FLEXERIL 10MG QHS PRN MUSCLE SPASMS, XARELTO 20MG PO DAILY, ATENOLOL 25MG PO BID, LISINOPRIL 20MG DAILY, PROZAC 20MG PO DAILY, GABAPENTIN 600MG PO TID, ATARAX 25MG PO BID ANXIETY, OXYCODONE 10MG Q4HR PRN, SINGULAIR 10MG Q
Current Illness: UNKNOWN
Preexisting Conditions: ETOH ABUSE X 15 YEARS, CHRONIC PAIN, HX OF ETOH WITHDRAWAL AND SEIZURES, L HIP LABRAL TEAR, HEMORRHOIDS, OSTEOARTHRITIS OF SPINE, FATTY LIVER
Allergies: NKDA
Diagnostic Lab Data: coronavirus coivd-19 pcr was positive on 4/11
CDC Split Type:

Write-up: 4/11/21 pt with pleurtic chest pain and worsening hypoxia. chest x-ray w/ bilateral pulmonary infiltrates. covid pcr + 4/11. pt admitted to hospital on 4/7 for alcohol withdrawal, minimal o2 requirements on admit. on 4/10 pt with low grade temperature and 02 requirements were increasing then, started on azithro 500mg daily x 3 days, patient did have chest ray that day with bilateral opacities.


VAERS ID: 1197672 (history)  
Form: Version 2.0  
Age: 38.0  
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, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 100 degrees F. Chills and body soreness. No treatments. Fever broke the next day, Continued soreness at the injection site.


VAERS ID: 1197720 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Carolina  
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 043A21A / 1 LA / SYR

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

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

Write-up: Fever, chills, dizziness, nausea, headache and fatigue started at about 10 hours after injection lasted for 16 hours. Dizziness was anytime I moved my head or tried to stand which would trigger nausea. Reporting because I was not expecting onset of severe symptoms at a 10 hour delay.


VAERS ID: 1197773 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Iowa  
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: Pharmacy       Purchased by: ?
Symptoms: Chills, Cyanosis, Headache, Pallor, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: Generic allergy medication, zinc tablet, vitamin B complex tablet, multi-vitamin tablet, herbal menopause relief tablets.
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to tree pollen.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills, fingers turned white, lips turned purple. Woke up at 1:30 am with headache and racing heart beat.


VAERS ID: 1197792 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Indiana  
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 042A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Feeling cold, Headache, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Asprin, blood thinner, beta blocker, b12, D3
Current Illness: None
Preexisting Conditions: Heart disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: These symptoms lasted 6hrs Cold chills, fever, nausea, headache, body aches, soreness at injection site. These symptoms lasted 12hrs Headache, soreness at injection site


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