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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 64 out of 1,889

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VAERS ID: 1203910 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Chills, Dizziness, Dyspnoea, Electrocardiogram, Hyperhidrosis, Palpitations, Syncope, Vital signs measurement
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported/denied any
Current Illness: none reported/denied any
Preexisting Conditions: none reported/denied any
Allergies: none reported/denied any
Diagnostic Lab Data: Nursing staff obtained vital signs. Paramedics performed blood glucose, EKG, routine vital signs.
CDC Split Type:

Write-up: Patient c/o dizziness, palpitations, SOB. VS within normal limits blood pressure 100/60, pulse 71, 97-99% Oxygen saturation. Diaphoretic, responsive with GCS 15. Denies existing health conditions, medications, or allergies. Given 1 bottle of water. Patient asked to walk with nurse. After walking 15-20 feet, patient said "whoa" and nurse grabbed patient and lowered him to the ground. Patient was placed supine and bag placed behind his head. Nurse unable to palpate carotid pulse and patient completely unresponsive. Nurse instructed to call 911 at this time. Patient positioned for CPR and opened his eyes. Stated "I fell asleep while I was walking." Patient instructed to lie still and informed 911 had been called. At this time, RN positioned patient''s legs upward to increase blood flow to chest and head. This nurse repeated blood pressure at this time 96/62. Nurse obtained heartrate 71-75 and oxygen saturation 98%. Denied pain. Stated he used a push mower in his yard this morning. Patient diaphoretic and chilled. Assisted into seated position to drink orange sports drink and a second bottle of water. Upon EMS arrival approximately 4 minutes after call, paramedics examined patient and took over his care. They measured a blood glucose level of 134. Nurses assisted patient into ambulance for paramedics to run an EKG. Patient later returned to his personal vehicle and remained on site for about an hour. He called his brother-in-law to assist him home. Nurses on site checked on patient every 10-15 minutes until his family member arrived.


VAERS ID: 1203923 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site swelling, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red, raised, itchy rash over injection site. Golfball sized lump at injection site. Started ~3 days after injection.


VAERS ID: 1203940 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A UN / IM

Administered by: Other       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncope


VAERS ID: 1203942 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-26
Onset:2021-04-11
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Aortic arteriosclerosis, Asthenia, Atelectasis, Blood chloride normal, Blood creatinine increased, Blood potassium normal, Blood sodium normal, Blood urea increased, Bone density decreased, Carbon dioxide normal, Chest X-ray abnormal, Cough, Dizziness, Fatigue, Haematocrit normal, Haemoglobin decreased, International normalised ratio normal, Lung infiltration, Mean cell volume normal, Platelet count normal, Presyncope, Prothrombin time normal, Pulmonary fibrosis, Pulmonary granuloma, Spinal osteoarthritis, Sputum discoloured, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteoporosis/osteopenia (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Arthritis (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CONTINUE taking these medications Details acetaminophen 500 MG tablet Commonly known as: TYLENOL Take 500 mg by mouth every 6 hours as needed for Pain Refills: 0 acetaZOLAMIDE 250 MG tablet Commonly known as: DIAMOX Take 1 tablet (
Current Illness:
Preexisting Conditions:
Allergies: Neurontin Latex
Diagnostic Lab Data: Lab Results Component Value Date WBC 12.3 (H) 04/12/2021 HGB 13.9 04/12/2021 HCT 43.6 04/12/2021 MCV 88.3 04/12/2021 PLT 252 04/12/2021 Lab Results Component Value Date CREATININE 1.6 (H) 04/13/2021 BUN 21 (H) 04/13/2021 NA 140 04/13/2021 K 3.5 04/13/2021 CL 105 04/13/2021 CO2 29 04/13/2021 Lab Results Component Value Date INR 1.0 04/12/2021 PROTIME 11.9 04/12/2021 XR CHEST PA AND LATERAL 2 VIEW Result Date: 4/12/2021 EXAMINATION: XR CHEST PA AND LATERAL 2 VIEW CLINICAL HISTORY: 67 years Male,near syncope. Cough COMPARISON: 3/18/2019 TECHNIQUE: Three radiographic views of the chest FINDINGS: Lungs are clear of active infiltrate. Mild bibasilar scarring and/or subsegmental atelectasis. Stable benign subcentimeter calcified granuloma at the right midlung zone. The cardiac silhouette is within normal limits. Pulmonary vessels are within normal limits. No pleural fluid. No pneumothorax. Generalized decreased bone density. Multilevel thoracic spondylosis. Aortic atherosclerosis. IMPRESSION: Benign chronic changes as detailed in the body of the report without active cardiopulmonary disease . Electronically signed by: MD 4/12/2021 9:42 PM
CDC Split Type:

Write-up: Chief Complaint Patient presents with ? Fatigue C/o feeling like he was going to faint since yesterday. Is feeling very weak. C/o still coughing and spitting up some green phlegm. Admitted to hospital


VAERS ID: 1204034 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A UN / IM

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

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

Write-up: Dizziness and syncope


VAERS ID: 1204048 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone, ziprasidone, temazepam, lamotrigine, vit d3, ashwagandha, sea moss, dulcilax stool softeners, vit c, fish oil, clonazepam, doxycycline, alvesco, albuterol
Current Illness:
Preexisting Conditions: Chronic headache,
Allergies: Chocolate, quinine, adhesives
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath and joint pain, since I got the shot. Use albuterol intermittently


VAERS ID: 1204122 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lip swelling, Pruritus, Pyrexia, Rash, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had a fever for 8 hours post-vaccine on 04/10/2021. On 04/11/2021, patient states fever resolved but then developed swelling around lips, "goose-egg lump on forehead", around 9AM. Swelling has moved from lips to jawline and still present on 04/13/2021. Patient reports having a "chicken pox like rash" on arms, "welt-like spot" on left inner wrist and ankle, and also had itchiness. Patient took cold-medicine hoping that would help with swelling. Patient states rash and welts have disappeared as of 04/13/2021. Patient advised to contact healthcare provider and consider taking Benadryl/antihistamine.


VAERS ID: 1204123 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cognitive disorder, Dysphonia, Feeling abnormal, Headache, Heart rate increased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prior to getting vaccination and on a daily basis: Vitamin D, Zinc, PanPlex Phase II enzyme, Candida/probiotic
Current Illness:
Preexisting Conditions:
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: shortly after vaccination (about an hour), I felt like I was disconnected in my words and responses. My husband would ask me questions and it took longer than normal to respond. That brain fog seemed to have subsided late afternoon. By 7pm the same day, I had chills, low grade fever and by 10pm the same day, I experienced extreme body aches, headache, and fast rate heart beat. I took an Aleve and by 2am, I was able to sleep and my heart rate was down. The next day, 4/12, I had a hoarse voice, body aches and a headache, no fever. Heart rate was still pretty fast.


VAERS ID: 1204138 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202 A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Fatigue, Headache, Pneumonia, SARS-CoV-2 test positive, Stress
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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? No
Previous Vaccinations:
Other Medications: valium 10 mg 1 x nitely (insomnia, major depressive disorder) hydroxyzine 20 mg 1x nitely (insomnia, major depressive disorder) prozac 20 mg 1 x am (major depressive disorder) vit d3 5000 iu daily Vitamin C 1000 mg daily Magnesium powder 36
Current Illness: none
Preexisting Conditions: fibromyalgia diagnosed with Lyme disease in 2009 (9 strains and Epstein Barr virus) have not been able to be tested for chronic lyme symptoms; health insurance will cover but provider will not refer me (PCP) Had a history of headaches after 7 years struggling with Lyme disease. They eventually subsided, if not disappeared. About 15 hours after receiving the J&J covid 19 vaccine, I had severe headaches and was so fatigued I could not get out of bed until Monday morning, April 12th..
Allergies: sulfa avoid refined sugars and carbs ie no sugar no flours; gluten free; dairy free; don''t eat much meat or fish
Diagnostic Lab Data: Covid 19 J&J vaccine 4/10/2021. feeling better as of 4/12/2021 but have read and understand I need to keep an eye out for next two to three weeks for any additional side effects. Reported to PCP but no follow up appointment has been scheduled. If I experience any further adverse events over the next few weeks I will reach out to this site again.
CDC Split Type:

Write-up: As described above, about 13 hours after the vaccine I woke up at 3 am with a severe pounding and constant headache. I was also extremely fatigued so much so that I did not get out of bed or do anything all day 4/11 and didn''t start feeling better until the following Monday. Then I hear in the news about the 6 adverse reactions and the J&J vaccine shutdown, possibility for blood clots etc. and to keep an eye out for various symptoms over next 2-3 weeks! It was stressful enough registering and not being able to secure the Moderna or Pfizer so I just said ok and got the J&J. Now I have something else to worry about. Heart and blood clot issues are in my family. I do not take any blood thinners and don''t plan to. But now am questioning whether I should have gotten the vaccine at all. I have had enough chronic illness in my life. In fact, December 2019 I was in another town taking care of my mother and her subsequent death when I caught someone''s cough. Urgent care diagnosed me with pneumonia, fluid in the lungs, put me on course of antibiotics. I couldn''t breathe, needed a nebulizer etc. They called me and said it was not pneumonia or flu a or b (I get the shot every year) and to go to the ER if it got worse. I couldn''t eat or move much for three weeks and breathing was extremely difficult. I had to get a nebulizer. Eventually went away. Then in March Covid 19 became official. When I tested for Covid 19 here at a state site in 2021, I tested negative.


VAERS ID: 1204173 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Platelet count decreased, Rectal haemorrhage
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (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: Zinc Vit C Vit D
Current Illness: N/A
Preexisting Conditions: heart murmur
Allergies: NKDA
Diagnostic Lab Data: PLT 146
CDC Split Type:

Write-up: Rectal bleeding about 5 days after vaccine, lasting for 3 days now. No SOB, CP, palps, dizziness, petechiae.


VAERS ID: 1204210 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Fatigue, Headache, Injection site erythema, Injection site pain, Pyrexia, Thirst
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 75mcg; Advil (2j; Citracal; Centrum Silver; Vitamin E 400iu; Claritin 10mg; Dr. Joint (3 pills BID); ASA 81mg
Current Illness: None.
Preexisting Conditions: Hypothyroidism.
Allergies: SULFA DRUGS
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Severe to moderate headache, fever (unknown first night and feverish feeling since), large joint and abdominal pain, very fatigued, thirsty, increasingly redness and tenderness at 8njection site and surrounding area over the past 2 days.


VAERS ID: 1204253 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Headache, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: Effexor XR (150mg), Trazadone(50mg), Amlodipine(10mg) and Lisinopril-HCTZ (20/12.5mg)
Current Illness: Bad cold. Cleared up 10 days before inoculation.
Preexisting Conditions: Elevated blood pressure. Taking blood pressure medicine currently as listed above.
Allergies: Sulfa and any protein pump inhibitors.
Diagnostic Lab Data: No laboratory or test conducted. No doctors or health clinics visited. Just laid in bed for three days as symptoms slowly went away.
CDC Split Type:

Write-up: Very bad headache, body aches, high fever and horrible pain in lower left abdominal area that lasted just over two days. All symptoms have nearly abated aside from the abdominal pain. However, abdominal pain is lessening each day. If these are considered normal side effects or adverse effects, i am unclear of. I just thought it would be best to report any effects to the vaccine.


VAERS ID: 1204271 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

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

Write-up: JANSSEN COVID-19 VACCINE EUA FEVER BEGAN 10 HOURS AFTER VACCINATION, TEMPERATURE 100.5 DEGREES. HAD THE CHILLS FOR SEVERAL HOURS, VERY LITTLE SLEEP, FEVER BROKE BY 7AM NEXT DAY OR 22 HOURS AFTER VACCINATION. AS DAY PROGRESSED WAS FEELING BETTER. TOOK IBUPROFEN 19 HOURS AFTER VACCINATION, THEN EVERY SIX HOURS THEREAFTER.


VAERS ID: 1204324 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Breast swelling, Chills, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins, minerals, flax oil
Current Illness: None
Preexisting Conditions: None
Allergies: Coding, cats, weeds, molds, smoke
Diagnostic Lab Data:
CDC Split Type:

Write-up: Onset next day Chills. Fever, body aches, joint pain, abdominal pain, left breast swelled to double the size


VAERS ID: 1204336 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Computerised tomogram normal, Depressed level of consciousness, Disorientation, Electrocardiogram normal, Electroencephalogram normal, Feeling cold, Hypotension, Loss of consciousness, Magnetic resonance imaging normal, Mobility decreased, Muscle tightness, Pain, Posture abnormal, Respiratory arrest, Seizure like phenomena, Throat tightness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro 20 mg, Tylenol 500 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Cat scan 4/11 EKG 4/11 MRI 4/11 EeG 4/11 All with normal results
CDC Split Type:

Write-up: Had seizure symptoms at 2:30 am the following day. Husband woke to our dog whining. I was very disoriented before it happened, I was freezing cold, aching, shooting pains, could hardly move or speak but got out the words, ?im not ok, I?m having a sever reaction? My husband said I then went into what he saw as a seizure. Head throat, neck, back tensed- unconscious, unable to arrouse. Lasted about a minute. Where I lied unconscious and he didn?t think I was breathing. 30 seconds later I opened my eyes, but then had a similar but shorter episode 30 seconds and then was able to get me to come to. He called 911, and they took me to hospital. All vitals came back normal. Blood pressure was on the low side. I have no history of seizures.


VAERS ID: 1204384 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Respiratory symptom
SMQs:

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

Write-up: Pt developed respiratory symptoms and presented to Urgent Care----was then transported to hospital


VAERS ID: 1204394 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Metabolic function test, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Substance abuse-Sober x 4 years
Allergies: None
Diagnostic Lab Data: CBC and CMP ordered, pending at time of submission
CDC Split Type:

Write-up: Awoke with right lower leg paresthesias. Intermittent, anterior aspect of leg, no other explanation for symptoms. Normal exam, no swelling, normal neuro exam.


VAERS ID: 1204440 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-29
Onset:2021-04-11
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Angiogram pulmonary abnormal, Chest X-ray normal, Dyspnoea, Echocardiogram, Echocardiogram normal, Full blood count normal, International normalised ratio normal, Prothrombin time normal, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, Tiazac, Omega 5, Aldactone, Vitamins
Current Illness:
Preexisting Conditions: CAD, Heart cath, Afib, DCIS s/p lumpectomy.
Allergies: Rosuvastatin, Brimonidine, Pilocarpine, Statins
Diagnostic Lab Data: 04/11/21. Labs normal: CBS, electrolytes, PT/PTT, INR. Chest xray and TTE normal.
CDC Split Type:

Write-up: Patient with mild shortness of breath for the past month. Travel a week ago. Received vaccine 03/29/21. Admitted on 04/11/21 for increased shortness of breath. CT angio showed extensive segmental pulmonary embolii. Patient doing well and discharged to home on 04/12/21 after being placed on Lovenox then transitioned to Eliquis.


VAERS ID: 1204684 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-05
Onset:2021-04-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Albumin urine, Blood thyroid stimulating hormone, Cerebral atrophy, Cerebral small vessel ischaemic disease, Computerised tomogram head, Full blood count, Glycosylated haemoglobin, Lipids, Magnetic resonance imaging head normal, Metabolic function test, Thyroxine free, Ultrasound Doppler normal, Visual impairment, Vitamin B12
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin, 20mg daily, Vitamin D3 2,000iu daily, Furosemide 20mg daily PRN, Gabapentin 300mg -3cap daily at bed, Asa 81mg daily, Meclizine 25mg daily prn, metformin 1,000mg -1 tab BID, ondansetron 4mg -1tab bid prn, pioglitazone15mg dail
Current Illness: N/A
Preexisting Conditions: Hx of colon cancer, DM type II, Vitamin b12 deficiency, hyperlipidemia, neuropathy, HTN, PVD, Chronic kidney disease, osteoarthritis involving multiple joints, Chronic low back pain, osteoporosis, vertigo
Allergies: Adhesive tape, prednisone, sulfa antibiotics
Diagnostic Lab Data: Radiology tests performed on 4-12-21 CT scan of the brain - cerebral atrophy with microangiopathic ischemic disease. MRI brain- No acute intracranial abnormality or evidence for acute ischemic infarction. US carotid doppler - Unremarkable ultrasound Labs performed on 4-11/4-12-21 Labs ordered, cbc, cmp, lipid panel, vitamin b12, microalbumin urine, tsh, t4 free, and A1c. Abnormal labs do not support patient''s complaint of visual changes.
CDC Split Type:

Write-up: Patient presented to pcp office with c/o visual changes. She stated her vision was blacked out when she woke on 4-11-21 and 4-12-21. She states it was like an ink blot on her eye that lasted for about 10 minutes. Patient denied any other symptoms at the time of visit.


VAERS ID: 1204828 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Chills
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Janssen COVID-19 Vaccine EUA Extreme shivering started after 7 hrs of the vaccine, followed by temperature of 101+ , which remained for most of next 20 hrs, even after taking 3 Paracetamol 650 over that duration. Temperature reduced after fourth medicine, Tylenol 500, after approximately 30 hrs of vaccination, and has stayed at approx 98 degree since.


VAERS ID: 1204928 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Nevada  
Vaccinated:1937-10-17
Onset:2021-04-11
   Days after vaccination:30492
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Heart rate increased, Hypopnoea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Chronic pancreatitis
Allergies: No known allergies
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: fever, pancreatic pain, rapid heart rate and breathing. (pancreatic pain was the main symptom that resulted in the patient going to and staying overnight in the hospital)


VAERS ID: 1204932 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 reports that the day after his vaccine her broke out in hives covering his entire upper body including torso, back both arms, neck and face. hives last for 24 hours required treatment with OTC benadryl l at home. hives went away after 24 hours and have not returned. patient also reports high fever of unknown because they did not have a thermometer for 24 hours


VAERS ID: 1205030 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Injection site pain, Nausea, 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), 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: ibuprofen
Current Illness: Pulled back muscle
Preexisting Conditions: None
Allergies: Peppers
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever two nights following the vaccination. Sweating and mild nausea the second night following the vaccination. Slowly fading pain at the injection site for three days following the vaccination.


VAERS ID: 1205367 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Cold sweat, Dizziness, Fatigue, Headache, Pain, Paraesthesia, Syncope, Time perception altered, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escotalopram 40 mg Tizanidine 4mg B 2 100 mg
Current Illness: Strep throat
Preexisting Conditions: Amplified Pain Syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/11/21 fatigue weakness slept 5 hours 4/12/21 chefs pain, clammy dizzy, fainted Headache 4/13/21 trouble tracking, time. Clammy, dizzy, fainted, headache, vomit, body aches, fatigue, tingling, shaking, cheats pain


VAERS ID: 1205376 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-31
Onset:2021-04-11
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Headache, Oropharyngeal pain, Pain in extremity, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Covid test 4/13/21
CDC Split Type:

Write-up: Headache, shortness of breath, leg pain, sore throat. Positive Covid test.


VAERS ID: 1205381 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache Fatigue Sore arm Fever Nauseous


VAERS ID: 1205390 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Diarrhoea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, severe body aches, chills, diarrhea, stomach ache from 5:30pm to 1:30am on 4/10/21


VAERS ID: 1205400 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 3469506-01508 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Disorientation, Dizziness, Headache, Mobility decreased, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Cancer
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started feeling dissy around 9:00 p. m. or shortly after then having a mild headache. As the night progressed I started having chills and the headache gotten worse. I took a ibuprofen and went to bed. In the morning I woke up feeling very weak with excruciating pain in my joints and muscles and a chronic headache. I could not move around without holding on because I was disoriented. This went on until the second day I woke up without the pain but still feeling weak in my legs and entire body.


VAERS ID: 1205433 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Intensive care, Malaise
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no info provided
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none provided
Diagnostic Lab Data:
CDC Split Type:

Write-up: Daughter reported patient was not feeling well. Took blood pressure reading and results were low. Called ambulance to take to hospital. Patient currently in ICU with unknown condition


VAERS ID: 1205478 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Write-up: Fatigue, muscle soreness, and slight fever


VAERS ID: 1205487 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Headache, Lethargy, Pain, Somnolence
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: I had no symptoms at all until the next morning when I woke up with a horrible backache. For all that day and the next day I was lethargic, just wanted to sleep, had mild bodyaches, and a very slight headache. not bad at all, especially compared to COVID-19!


VAERS ID: 1205509 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperpyrexia, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: gianvi
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: got a fever of 106 degrees about seven-eight hours after the shot. it got up to 107.2 degrees. started throwing up about 10 hours after the shot. went to the hospital. was given an iv bag and some anti nausea medicine. after about a day and a half i felt better.


VAERS ID: 1205554 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Headache, Nasal congestion, Nausea, Pain, Pain in extremity, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: None at time.
Preexisting Conditions: N/a
Allergies: Bacterium, amoxicillin and penicillin
Diagnostic Lab Data: None been at home. Do not have pcp
CDC Split Type:

Write-up: Chills, fever , nauseous, sore arm, vomiting , nasal congestion, mild cough, headaches and body aches


VAERS ID: 1205566 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-11
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1805031 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: The first, important piece, is this is the first Vaccine I have had in 34 years. Last Vaccines was in 1982 when I enlisted in the Air Force and got lots of vaccines. I experience reflect pain symptoms. I got the shot in my left arm but my right arm felt the soreness along with tingling on my right side. On Sunday, April 11, 2021, I started to feel my right leg with pain on a scale of 6 out of 10. As I report this issue pain is still at a six (6) Otherwise, I feel fine. Opened a Case #172073


VAERS ID: 1205573 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Body temperature increased, Dyspnoea, Headache, Lethargy, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega-3 Xanax
Current Illness: None, but I did have covid in early January 2021
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Beginning approximately 12 hours after vaccine, I had fever of 101.5, severe headache, severe joint/leg/back pain, shortness of breath and severe lethargy. Basically, I felt like I was having covid all over again.


VAERS ID: 1205589 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 340A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Antineutrophil cytoplasmic antibody, Antinuclear antibody, Blood creatine phosphokinase, Blood test, Blood uric acid, Body temperature increased, C-reactive protein, Chills, Eye pain, Fatigue, Full blood count, Headache, Metabolic function test, Photophobia, Stomatitis, Throat irritation
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: None NOTE: Family history of autoimmune diseases - hashimoto?s and sojogren?slike syndrome (mom), dermatomyositis (MGM), graves d/o (mat aunt)
Preexisting Conditions: Atopic Dermatitis
Allergies: NKDA Seasonal allergies Cats
Diagnostic Lab Data: Labs drawn on 4/13 at 17:00; results pending as of this writing. - CBC w/ platelets -CRP Metabolic panel CPK Uric Acid Antinuclear antibody (ANA) Anticardiolipin antibody IgG IgA IgM
CDC Split Type:

Write-up: Fri 4/9/2021- Immediately upon receipt of vaccine, reported prickliness of soft palate and ?heaviness in throat?. Was observed for ~ one hour due to these symptoms q 10 assessments of vital signs, all of which remained normal at each measurement (100/60, o2 sat 97-99%, RR 12/min, HR 66). Provided with water to drink. Later that day (fri 4/9) ? c/o of headache, tiredness, chills, low gr temp (100.5). No resp c/o. no body aches. Sat- 4/10- slept most of day. Drank fluids (water, soup), nml urine. Began advil 400 mg bid-tid. When awake, c/o Persistent headache, Sun 4/11- c/o persistent headache, now with pain behind his eyes, and photophobia. No blurred vision. Denied sinus pain, nasal d/c or any visual changes. Applied cold spoons to his eyes with minimal relief. No sinus, nasal, or visual c/o. Continued motrin 200 mg po bid-tid. Mon 4/12- vaccine symptoms abating, eating normally, still tired and with HA (unchanged) and eye pain (unchanged). Noted eye worse when looking t upper and lower extreme corners of visual fields. No sinus, nasal, or visual c/o, EOM intact but w/ pain when looking at superior and lateral fields (r&L). (said this optic complaint was true all along, but only at this point was able to describe it). Tues 4/13- Because of the unusualness of complaint and the "J&J Pause", patient given given 1 adult aspirin & evaluated by (optometrist). Exam (including dilation) Nml optometric exam ( normal visual fields, visual acuity, color vision, eye pressures (14 bilateral); normal range of extra ocular movements, though pain reproduced at the extreme corners of the visual field; normal vessels and discs; NO evidence of optic neuritis)


VAERS ID: 1205610 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J&J 202A21A / 1 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal discomfort, Arthralgia, Back pain, Chills, Dizziness, Feeling hot, Headache, Muscle spasms, Nausea, Pain, Palpitations, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC probiotic Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None I called my PCP to report the effects today and they called me back to acknowledge receipt.
CDC Split Type:

Write-up: 5 hours after shot, I felt a slight ache in my knee. Within the hour, my whole body was engulfed in aches, chills, pain and uncontrollable shaking. Then my head starting hurting and I felt extremely hot. My legs and chest were pink and hot to the touch. Very high fever, head pain , nausea and heart palpitations. I took Tylenol which helped with the fever. The next day I had some minor aches and dizziness. Later the same day, I had sharp aches/pains down my back and an upset stomach. That night I had a fever again but not as high. Today, two days later, I feel back to normal with the occasional ache or cramp.


VAERS ID: 1205695 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Limb discomfort
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right leg heaviness and pressure. No weakness. No erythema. No swelling.


VAERS ID: 1205701 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ANEMIA
Allergies: NONE
Diagnostic Lab Data: BLOODWORK AND FACIAL & CHEST XRAYS ON 4/11
CDC Split Type:

Write-up: I PASSED OUT ON DAY 2 WHILE OUTSIDE AND REQUIRED STITCHES. WHILE AT A MEDICAL FACILITY GETTING X-RAYS, I PASSED OUT A SECOND TIME AND WAS RUSHED TO THE EMERGENCY ROOM.


VAERS ID: 1205780 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, 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
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: He got the Johnson and Johnson shot. Soon after going to bed that night he vomited. The next day he felt tired and had little appetite.


VAERS ID: 1205784 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK RA / IM

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

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

Write-up: At 10PM (8 hours after getting the JnJ vaccine) pt developed chills and pulsate headache. Pt was able to sleep. Next day in the morning by 7:40AM she went downstairs and got dizzy and fall gradually on the floor. Pt got help, but when she was trying to get up she got lightheaded/passed out again bumping her head on the wall. Pt reacted, fluids were given. Pt slept all morning. At 2PM she got up from bed. No pulsate headache, just "mild headache." Today, 48 hours later, pt reported light headache. Denies abdominal pain or pain in extremities. Pt and parents of pt were encouraged to report to patient''s PCP.


VAERS ID: 1205805 (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: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Dizziness, Feeling abnormal, Headache, Malaise, Myalgia, Nausea, Neck pain, Photophobia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (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: Zyrtec (OTC).
Current Illness: None known / observed.
Preexisting Conditions: None known.
Allergies: None known.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 10 April 2021: 14:00 J&J Covid-19 vaccine. No issues whatsoever throughout day, neither muscle soreness at injection point, nor fatigue etc. 11 April 2021: Woke having had headache and left shoulder/neck muscle soreness affect sleep. Woke ~09:00. Headache became worse, & minor chills. Had breakfast (toast w/Vegemite). Drank lots of water. Through day, felt worse (notably headache, fatigue). Had lunch ~12:30 (salad and jerkey), but quickly felt unwell with it. Interrupted phone call at ~13:45 to go to bathroom, feeling nauseous Felt a bit dizzy, having to stabilize my walking around apartment a couple times, but mostly feeling mentally foggy/unclear. Struggled with some sentences on phone calls.


VAERS ID: 1205815 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood ketone body, Blood test, Chest X-ray, Chest pain, Chills, Electrocardiogram, Pain, Pain in extremity, Urine analysis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 04/11/2021 full blood work , chest x-ray and ekg. Urine test.
CDC Split Type:

Write-up: Chills, severe aches, pain in my left arm down to my hand , neck, back, chest, keytones due to type 1 diabetes.


VAERS ID: 1205830 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Pain, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Janssen Covid-19 Vaccine EUA First 12 hours after the shot I experienced headaches, body aches, and chills. Within the next 24 hours all of these symptoms increased severely, and around 5pm on 4/11/21 I experienced a seizure that resulted in me being taken to the ER.


VAERS ID: 1205832 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-23
Onset:2021-04-11
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 5 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Fatigue Hyperlipidemia
Allergies: None
Diagnostic Lab Data: Sent to ED ( we did discuss MRI/CT/blood tests etc.)
CDC Split Type:

Write-up: Called this evening 4/13/21 at 6PM complaining of severe headache with dizziness which started two days ago. She was referred to an Emergency Department which is the closest facility to her. She agreed to go at 6:05PM. We called the ER to advise them that she needs to be worked up for a complication of the vaccine.


VAERS ID: 1205866 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

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

Write-up: Dizziness, nausea, hives, headache, fever.


VAERS ID: 1205885 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206AZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature fluctuation, Chills, Dizziness, Hyperhidrosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: First night began with a slow rising fever. Next day had severe fever of at least 101 or 102 with chills and sweats. Dizziness and extreme temperature swings


VAERS ID: 1205908 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Fatigue, Headache, Insomnia, Pain, Stress
SMQs:, Hypoglycaemia (broad)

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

Write-up: Head ache body ache fatigue physical pain stress and anxiety. Lack of sleep.


VAERS ID: 1205939 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-11
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Dysarthria, Lacrimation increased, Magnetic resonance imaging
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Lacrimal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atenolo, levothyroxine, Prevacid, multi vitamin, Vit C, Vit D3, B complex, zinc, vit E, vit A
Current Illness: Seasonal Allergies
Preexisting Conditions: Hi BP, thyroid, GERDS
Allergies: Sulfur
Diagnostic Lab Data: Ct and MarI
CDC Split Type:

Write-up: All was fine till day 9 evening when my right eye kept watering, and I brushed my teeth water shot out right side. Next day same thing with blurred speech. I went to hospital, had CT n MRI. No blood clot determined its bells palsy. I have been healthy accept for mild seasonal allergies


VAERS ID: 1205997 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Body temperature increased, Chest discomfort, Chest pain, Chills, Confusional state, Dizziness, Headache, Myalgia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: amoxicillin, tb skin test, grass, dust mites
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Approximately 4 hours after receiving the injection, I started developing a fever, within an hour it had reached 103.3 F. At this point I took 400 mg of over the counter ibuprofen which helped drop my temperature slightly to approximately 102.2 F. This fever continued into the night. I took another dose of ibuprofen before sleeping, about 6 hours after the first dose. Along with fever I experienced strong shaking/chills, muscle and joint soreness, headache, dizziness, confusion, and chest pain/feeling of pressure on the chest. The day after vaccination I continued to have a low-grade fever of approximately 100 F which subsided by evening. All other symptoms subsided as well except for the chest pain. On the second day post-vaccination my only remaining symptom is the chest pain.


VAERS ID: 1206001 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain lower, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitafol ultra (vitamins)
Current Illness: I had a flu week prior, was tested for COVID-19 it was negative. I had my monthly periods at the time.
Preexisting Conditions: No. Only seasonal allergies.
Allergies: No knowing allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe sharp pain from the waist down. It lasted about 24 hrs. Two 325mg Tylenol every 3-4 hrs helped.


VAERS ID: 1206102 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-01
Onset:2021-04-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

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

Write-up: Head ache, tiredness, always sleepy


VAERS ID: 1206109 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Injection site pain, Injection site swelling, Injection site warmth, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bayer and Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet trying to get a doctors appointment
CDC Split Type:

Write-up: left arm has bump on Injection site it?s also very warm and tender to the touch headaches left side very tired fevers nausea lost of appetite


VAERS ID: 1206118 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Bone pain, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Osteonecrosis (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 Bones ache Headache


VAERS ID: 1206196 (history)  
Form: Version 2.0  
Age: 1.83  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control, Zofran
Current Illness: Patient has been dealing with anxiety and chronic nausea associated with anxiety
Preexisting Conditions: ovarian cyst, anxiety
Allergies: NKDA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: localized reaction at vaccine site. Mild induration with quarter sized area of erythema. and a second nickel sized area of erythema superior to site


VAERS ID: 1206212 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Dizziness, Dyspnoea, Epistaxis, Fatigue, Heavy menstrual bleeding, Migraine
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

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

Write-up: No side effects until day 5 (Sunday) after vaccination which were: Migraine, nosebleed, light-headed, weakness, easily winded/fatigued, abdominal pain, heavy menstrual cycle, diarrhea. All side effects ended within 24 hours after they started except for heavy menstruation and fatigue.


VAERS ID: 1206213 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling abnormal, Headache, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Dizziness, brain fog, fever, chills, headache, and all over sore muscle aches.


VAERS ID: 1206352 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tiredness, serve body aches and slight headache for 3 days.


VAERS ID: 1206990 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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-Medium, Systemic: Flushed / Sweating-Mild


VAERS ID: 1207040 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 95838 / 1 - / SYR

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

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

Write-up: Leg aches


VAERS ID: 1207065 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Dyspnoea, Injection site pain, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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: Advil
Diagnostic Lab Data:
CDC Split Type:

Write-up: Abdominal pain, pain on the injection site, trouble breathing on small occasions, body pain


VAERS ID: 1207285 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Febrile neutropenia
SMQs:, Agranulocytosis (narrow), Haematopoietic leukopenia (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: B-cell lymphoma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: febrile neutropenia


VAERS ID: 1207344 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control, oral pill.
Current Illness: When vaccine was received was on period.
Preexisting Conditions: Migraines.
Allergies: Allergic to Vicodin.
Diagnostic Lab Data: Had a CBC test done, it came back normal.
CDC Split Type:

Write-up: Large blood clots- that are not normal for my period. Large clots, 1/2 dollar size 4-5 times a day. Which is not normal, my period should be winding down, and it is ramping up and at like Period Day 6, bleeding through a pad an hour or 2 hours and large clots. Clots started and higher bleeding after the vaccine.


VAERS ID: 1207392 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-05
Onset:2021-04-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Angiogram abnormal, Deep vein thrombosis, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: CTA chest, Venous duplex of R LE
CDC Split Type:

Write-up: Acute bilateral PE and acute DVT


VAERS ID: 1207394 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vivelle-Dot (Estrogen) Transdermal Patch Progesterone 200mg capsule Spironolactone 50mg tablet
Current Illness: None Reported
Preexisting Conditions: Post-menopausal
Allergies: No Known Drug Allergies
Diagnostic Lab Data: None at time of reporting; patient had plans to see physician
CDC Split Type:

Write-up: On the evening of 04/11/21 patient states she began to have some vaginal blood spotting, on Monday 04/12/21 patient reported vaginal blood flow. Patient reports she is post menopausal and has not had a period, spotting, or blood flow in years.


VAERS ID: 1207461 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Dermatitis bullous, Laboratory test normal, Rash erythematous, Rash vesicular
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Septic workup negative Meningitis panel negative
CDC Split Type:

Write-up: Bullous/blistering erythematous rash covering most of the body. Mostly on the scrotal/inguinal area and looks like an induced hypersensitivity reaction.


VAERS ID: 1207613 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Eye movement disorder, Fall, Foaming at mouth, Head injury, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Was sitting in chair, fell over. Hit head on cement floor. Seized for 35 seconds. Eyes rolled in to back of head and foaming at the mouth. Awakened suddenly to confusion. Escorted off floor to wheelchair. Reoriented.


VAERS ID: 1207632 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site nodule, Injection site pain, Injection site pruritus, Injection site warmth, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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: Bupropion HCL XL 150 mg ( qty 1) Gemfibrozil 600 mg (qty 2) Vitamin D3 1000iu 25 mcg (qty2)
Current Illness: None
Preexisting Conditions: Obese Back pain Knee pain
Allergies: No know allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA injection was on Saturday. Injection site became hot and very painful late Sunday. The pain has not decreased over these several days and radiates down to my thumb. Monday the site became raised and has a hard bump under the skin. Tuesday the raised hard bump has a slight peak similar to a mosquito bite and is becoming itchy. Today/Wednesday there has been no decrease in symptoms.


VAERS ID: 1207671 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Head discomfort, Pain, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: FEVER, ACHES, DIZZINESS, PRESSURE, TIREDNESS NOT AFFECTING DAILY LIFE, ABLE TO RUN ETC. HOWEVER STILL HAVING SOME DIZZINESS AND TIREDNESS. RECOMMENDED CHECKING WITH MD


VAERS ID: 1207737 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-07
Onset:2021-04-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Erythema, Insomnia, Pain, Pain in extremity, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 10 mg - Benazepril 20 mg 1 daily Naproxan 5 mg 2 x daily Methylprednisolone 4 mg 1 daily Gabapentin 300 mg 1 q HS
Current Illness: Hypertension Scoliosis Obesity
Preexisting Conditions: Hypertension Scoliosis Obesity
Allergies: NA
Diagnostic Lab Data: CT Scan
CDC Split Type:

Write-up: Pain, swelling, redness, bruising, tenderness, hot to touch, unable to sleep on left side due to pain


VAERS ID: 1207772 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Angiogram, Back pain, C-reactive protein increased, Catheterisation cardiac, Chest pain, Dizziness, Electrocardiogram normal, Fibrin D dimer increased, Hospitalisation, Nausea, Pain in jaw, Pericarditis, Troponin increased
SMQs:, Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo Loestrin FE 1mg-10mcg/10mcg
Current Illness: NONE
Preexisting Conditions: Anxiety, GERD
Allergies: NKDA
Diagnostic Lab Data: + elevated Troponin, Elevated D Dimer, Elevated CRP Had Cardiac Cath, CTA chest, Echo - normal EKG with inferior and lateral STE
CDC Split Type:

Write-up: CHest pain radiating to Back and Jaw , nausea , lightheadedness , Admitted for 2 days to hospital for testing Diagnosed with Pericarditis-


VAERS ID: 1207852 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Pain
SMQs:, Peripheral neuropathy (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: Levoxyl
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches, feeling burning almost like when having shingles.


VAERS ID: 1207881 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Malaise, Somnolence, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: spirnolactone 25 mg 1 tab daily tri-Lo-Marzia tab 1 tab daily Aderrall 15 mg 1 tab TID
Current Illness: none
Preexisting Conditions: none
Allergies: Nuts NKDA
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: patient recieved J& J vaaccine on saturday at 2 pm following am patient woke up walked to bathroom told mom she wasnt feeling well, mom noticed she was going to pass out and assisted patient to ground, syncope lasted < 30 sec. Patient drank water/ginger ale, patient returned to sleep and woke up and reported feeling normal Patient took an adderrall 15 mg saturday night around 6 pm after vaccine to do school work Patient ate and drank normally saturday night patient has period currently- normal bleeding normal cramping patient on tri lo marzia BC and on spirnolactone for acne Of note patient does report hx of syncope in the am 1 year ago- never seeked treatment it was non recurrant Patient also states that a couple times a week she wakes up feeling dizzy- last about < 1 min and goes away.


VAERS ID: 1207907 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Differential white blood cell count normal, Full blood count, Gait disturbance, Headache, Impaired work ability, Malaise, Pain in extremity, Weight bearing difficulty
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Geodon 20mg , Geodon 60mg, hydroxyzine pamoate 50mg, Zyrtec 10mg
Current Illness: None
Preexisting Conditions: None
Allergies: No know allergies
Diagnostic Lab Data: Dr ordered CBC w/diff stat and send patient to medical center, to ER. Pt was sent via state care
CDC Split Type:

Write-up: Patient in clinic for sick call. Pt having random bruising and pain in his LE patient does have limp favoring his rt leg. Pt reports having random bruising ever since he received the Johnson and Johnson vaccine. states that he has been having headaches and pain in his feet. Pt reports head aches started about 3 days ago. Pt does report history of family members having clotting issues. Tem 97.8, B/P 105/75, P88, resp 16


VAERS ID: 1207945 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Cough, Decreased appetite, Dehydration, Dizziness, Feeling cold, Feeling hot, Headache, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (narrow)

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

Write-up: (Saturday)When I came home after I received the vaccine I didn''t really have anything to do, so I decided to take a nap and rest. I think after I woke up is when I started to feel the side effects. I can''t remember exactly but I started feeling cold. I didn''t think too much of it I just thought it was a cold day (which was quickly turning to night). Later that night I started feelinga bit dizzy and my head was hot but I still had chills. Since I had a had a blanket with me, and I think I was starting to feel what would become muscle aches, I just didn''t want to move from the couch to my room. Feeling chills the rest of the night, I realized it was bad choice, since one of my family members left a window open. The cold air of the night really exacerbated my chills. Despite the cold I was still able to sleep, but the next day (Sunday) I did have a slight cough which I think was from experiencing the cold air of the night and not a side effect from the vaccine. (Sunday) This is when I really felt all the side effects. I felt weak, chills, headache, dizziness, muscle aches,(I''m not sure if I had a fever, I couldn''t think clearly my head felt hot). I haven''t had a hangover but I think that is what it would feel like to have one. I basically slept most of day Sunday ; This time in my room with 3 blankets (light blankets )and heat up (felt like 80F under blankets). I was sweating under the blankets but it really helped warm me up and alleviate my chills. I woke up later that day to a call to help my sister with some work. I couldn''t drive, felt weak and dehydrated(dark orange/yellow pee), but she insisted so she picked me up and scolded me for not eating anything all day(besides the side effects I mention, I think I may have also lost my appetite because I felt dizzy). I was still feeling my head aching after I woke up, still had muscle aches and a slight cough too. It was raining that day so I put on a winter coat with layers underneath to help with my chills. At her home she gave me a Gatorade (and water) which I think really helped since I was sweating a lot under the blankets when I fell asleep. She also gave me some home cooked meals she made. The combination of drinks, food, and familial concern really helped me recover. By Monday my cough was gone and the side effects had worn off to the point that I could go to work safely. My mother & father also received vaccine at the same time I got it. My father also experienced side effects but his started later with the most effects felt on Tuesday. My mother did not get any side effects.


VAERS ID: 1207997 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202AZIA / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain lower, Chest X-ray, Computerised tomogram, Diverticulitis, Laboratory test, Urine analysis
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific inflammation (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Low dose aspirin Clarion Birth control pills
Current Illness: None
Preexisting Conditions: PCOS
Allergies: None
Diagnostic Lab Data: 4/12- urine, blood, chest X-ray and CT with contrast
CDC Split Type:

Write-up: Severe abdominal pain on lower left side began 3am 4/11/21 and continued throughout the day. I sought medical treatment at 10:30am 4/12 at the ER. Through CT scan with contrast, the doctor determined it was diverticulitis and treated with antibiotics. I am still recovering, no history of diverticulitis, and unknown if this is an adverse effect.


VAERS ID: 1208068 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose, Blood magnesium, Feeling abnormal, Laboratory test, Muscular weakness, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion XL 300 mg.
Current Illness:
Preexisting Conditions: Depression/asthma
Allergies: None
Diagnostic Lab Data: 4/14/21- Complete blood tests, magnesium, blood sugar.
CDC Split Type:

Write-up: On Sunday an Monday after the shot I had muscle weakness. I felt fine by the end of Monday night, but then on Tuesday morning I started to feel weird brain surges and getting shaky like I was on drugs or something. I went to the ER and they said it''s vaccine related and that I just wait it out.


VAERS ID: 1208074 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-06
Onset:2021-04-11
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain, Thrombocytopenia, Thrombotic thrombocytopenic purpura
SMQs:, Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Renovascular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Seasonique Tylenol Vitamin C
Current Illness: Low grade fever for a few days and sore arm
Preexisting Conditions: N/A
Allergies: Seasonal Allergies
Diagnostic Lab Data: Plasma exchange and hospitalization.
CDC Split Type:

Write-up: Thrombocytopenia and severe abdominal pain concerning for thrombotic thrombocytopenic purpura.


VAERS ID: 1208090 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-01
Onset:2021-04-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Verpamil, Losartin, Metopolol, Vitamin C, B-12, Biotin,
Current Illness:
Preexisting Conditions: Type 2 diabetes, Cholesterol, Hypertension
Allergies: None
Diagnostic Lab Data: Ultrasound at The Hospital.
CDC Split Type:

Write-up: Left leg DVT April 11, 2021. Johnson and Johnson vaccine on March 12, 2021


VAERS ID: 1208141 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Full blood count normal, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Onfi 20mg BID; Trileptal 300mg BID
Current Illness:
Preexisting Conditions: Epilepsy, ITP, Hx of Hodgkin''s Lymphoma
Allergies: Lamotrigine
Diagnostic Lab Data: CBC with normal platelets
CDC Split Type:

Write-up: Seizure


VAERS ID: 1208142 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Blood pressure increased, Blood pressure measurement, Blood test, Electrocardiogram, Heart rate, Nausea, Orthostatic hypotension, Oxygen saturation, Palpitations, Sinus rhythm
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (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: Lysine Vitamin D3 Zinc
Current Illness: None
Preexisting Conditions: Arthritis Skin cancer
Allergies: Clams
Diagnostic Lab Data: Transported to Hospital . Blood work came back normal, EKG sinus rhythm and normal blood pressure before discharge.
CDC Split Type:

Write-up: Head rush and heart palpitations approximately 10 minutes after injection, and nausea. Assisted by EMTs to monitor heart rate, blood pressure , and blood oxygen level. Went into atrial fibrillation and blood pressure steadily rose. 165/99 was one reading I heard them call out.


VAERS ID: 1208163 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       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:
Current Illness: N/A
Preexisting Conditions: N.A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: 102 fever, body chills, body aches for 12 hours starting 11pm on Sunday, April 11th (about 8 hours after vaccination). Continued pain in sight of injection and body aches for third day now.


VAERS ID: 1208202 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blue toe syndrome, Burning sensation, Erythema, Migraine, Pain in extremity, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Augumentin, Norvasc, Atrovastatin, Motgrity, Prozasc, Chantix,
Current Illness: Leg issues
Preexisting Conditions: High cholesterol, High blood pressure, Cirrhosis of liver, chronic pain
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient started having swelling in both legs and pain in the on 4/11/21 at night. States that legs turned red, burning, tingling and toes were bluish tinged. Contacted heart specialist on Monday and was instructed to put on compression hose and elevate has appointment with him on Thursday. Also had a migraine headache that started Saturday night that continues today.


VAERS ID: 1208254 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-04-11
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute respiratory failure, Chest X-ray abnormal, Chills, Dyspnoea exertional, Hypoxia, Lung disorder, Pyrexia, Suspected COVID-19
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prilosec Imitrex
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest x-ray with COVID-19 pneumonia features
CDC Split Type:

Write-up: presented to the emergency department for evaluation of fevers and chills and was eventually admitted to the hospital with concern for COVID-19 pneumonia with acute hypoxic respiratory insufficiency with exertion


VAERS ID: 1208321 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Hallucination, Headache, Malaise, Nausea, Pain, Pyrexia, Somnambulism
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: Adderall
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 103 fever, severe headache lasting 48 hours, chills, severe achey pain and unwell feeling, nausea. Sudden night waking with seeming hallucinations.


VAERS ID: 1208392 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

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

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

Write-up: Increasing nausea and headache starting five days after injection.


VAERS ID: 1208414 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: wellbutrion 300mg XL naproxen
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: mild fever - 99.5 flu like body aches (lasted about 1 day)


VAERS ID: 1208467 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042192119 / UNK LA / SYR

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

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

Write-up: Significant ringing is occurring in my ears. Never had any symptoms or ear problems in the past and it is now non stop.


VAERS ID: 1208495 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Headache, Influenza like illness, Injection site pain, Night sweats, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (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: Multi-vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Pets, seasonal
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Woke up with 100 degree fever around 5:00am, 1 day post-vaccination. Fever persisted 24 hours, with intense night sweats. Other flu-like symptoms included headache and eye pain. Eye pain persisting until time of this report. Eye movement is painful, but no blurred vision. Sore arm persists.


VAERS ID: 1208535 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Headache, Injection site erythema, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, chills, aches, tired, diarrhea, redness swelling in arm, headache. 2 days


VAERS ID: 1208572 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Headache


VAERS ID: 1208644 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal 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:
CDC Split Type:

Write-up: Minor blurred vision on the next morning and lasted about 6 hours then vision came back at late evening


VAERS ID: 1208730 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Feeling hot, Hyperhidrosis, Impaired work ability, Peripheral coldness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I did not take any supplement or medication
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had the shot on Sunday. After the shot, I feel dizzy and felt asleep. On the same Sunday night around 12 a.m. , my body is so chill and I kept on sweating. It has been for three days till Wednesday, my body is so warm, sweating, tired,hand palm and feet is so cold everyday, low energy, cannot focus on work.


VAERS ID: 1208736 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Dry mouth, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (broad)

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

Write-up: My Stomach hurts so much and my mouth is dry and i throw up sometimes


VAERS ID: 1208747 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Musculoskeletal pain, Pain in extremity, Sciatica
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: buPROPion HCL (WELLBUTRIN XL) 150 mg 24 hr tablet- Take 1 Tablet by mouth every morning busPIRone (BUSPAR) 5 mg tablet - Take 1 Tablet by mouth 2 (two) times daily After 1 week increase to 2 tablets in the morning and one in the evening.
Current Illness: None.
Preexisting Conditions: Anxiety, Depressive Disorder, GERD
Allergies: Penicillin
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Pt reports 7/10 left leg pain starting late evening of 04/11/21 similar to a sciatic pain. Prescribed gabapentin 300mg TID for pain on 04/13/21. On 04/13/21, pt reports to MD that the pain is mid buttock and all the way down the leg and then up to the bottom of her lower back. Butt pain is sharp and consistent, shoots down to the ankle on the back of the leg. Not relieved by stretching.


VAERS ID: 1208751 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, 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 just seasonal allergies
Diagnostic Lab Data: I have not had any.
CDC Split Type:

Write-up: 12hours after vaccine fever started, I have had a fever between 102 and 103,1 since 12 2hours after getting the vaccine. Itake tylenol and it goes down. I have also felt tired and with a headache.


VAERS ID: 1208883 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: swollen/red around site of administration as well as left arm/wrist


VAERS ID: 1208906 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins, Zyrtec and Biotins
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type: 043A21A

Write-up: Covid arm, red bump under the shot, itchy and it hurts


VAERS ID: 1208996 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Electrocardiogram normal, Heart rate decreased, Loss of consciousness, Tremor
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), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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: Prescriptions: Zetia, Rosuvastatin, Levothyroxin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG was performed and was normal, as was my bloodwork. So far, I am feeling normal with no other side effects.
CDC Split Type:

Write-up: Approximately 4-5 after receiving the Covid Vaccination, my heart rate dropped, the top of my body was shaking and I passed out. The ambulance arrived and took me to the ER. My heart rate was at 40 . I was in the hospital for observation for 3+ hours.


VAERS ID: 1209002 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Influenza like illness, Pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Flu like symptoms with severe stabbing chest pain. Started to feel achy and a twinge in chest around 12:30 am, went to sleep, woke up at 2 am with severe stabbing pains in chest that would come and go. Took some Advil around 3:15am and within a half hour flu like symptoms stopped but not chest pains. The chest pain were less severe. Continues to feel a slight twinge and slight aching in chest 4 days later.


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