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From the 10/15/2021 release of VAERS data:

Found 8,070 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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VAERS ID: 1574364 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fall
SMQs:, Accidents and injuries (narrow)

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

Write-up: Patient fell to the ground at approximately 11:33. Vital signs assessed. Ems contacted and transported patient out of center.


VAERS ID: 1574370 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Kentucky  
Vaccinated:1963-11-01
Onset:2021-04-01
   Days after vaccination:20971
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Intensive care, Pneumonia, Sepsis
SMQs:, Anaphylactic reaction (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), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Acute hypoxemic respiratory failure d/t COVID19/sepsis d/t pneumonia requiring ICU admission


VAERS ID: 1574382 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, novolog, treshiba, ropinorole, ranolazine, prasugrel, sacubitril-valsartan, Jardiance
Current Illness: None
Preexisting Conditions: CAD, CHF, Type 2 Diabetes, asthma, sleep apnea, pacemaker defibrillator, obesity.
Allergies: Plavix
Diagnostic Lab Data: Tested positive for COVID19 with rapid test one week after receiving shot. Started COVID19 treatments and medications, including monoclonal antibody treatment.
CDC Split Type:

Write-up: Headache, runny nose, congestion, cough, body aches, fatigue. Scratch throat and cough started 3 days after receiving shot, runny nose, congestion, body aches and fatigue started 5 days after shot.


VAERS ID: 1574482 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043821A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Pallor, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: PT MONITORED FOR 1ST 15MINS POST-VACCINATION - PT C/O DIZZINESS AND LIGHT-HEADEDNESS, PROVIDED WATER, PT REPORTED SHE HAD EATEN LUNCH PRIOR VACCINATION. PT RECOMMENDED TO STAY AT VACCINE SITE, PAST 30MINS FROM RECEIVING THE VACCINE, PT BECAME PALE, CLAMMY, AND ALMOST FAINTED, PT WAS STILL AWAKE AND ORIENTED. VITAL SIGNS WERE STABLE. RAPID RESPONSE CALLED, PT TRANSPORTED VIA GURNEY TO HOSPITAL''S ER FOR FURTHER WORKUP. PT WAS LATER DISCHARGED FROM ED, NO COMPLICATIONS. PT WAS STABLE.


VAERS ID: 1574485 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-05
Onset:2021-08-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abscess jaw, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (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? Yes
Hospitalized? No
Previous Vaccinations: Tdap
Other Medications: Pantoprazole SOD DR 40mg 1HS Fluticasone Prop 50mcg spray 2 TID allergies Leflunomide 20mg Tab daily ondansetron ODT 4mg tab PRN Levalbuterol 0.63mg/3ML sol Levalbuterol inhaler PRN Methotrexate 2.5mg 2tabs twice a week Folic Acid 1mg tab d
Current Illness:
Preexisting Conditions: Asthma, migraine disorder, hypothyroidism, Hashimoto disease, autoimmune inflammatory arthritis, fibromyalgia, siezures, diverticulitis, tremor, hypertension,
Allergies: Gluten Dairy seasonal sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On 8/6/21 Client reports welts in her mouth, on her face and arms. Took benadryl and a breathing tx. Then on 8/8/21 client presented to the ER with more swelling. Diagnosed with an abscess to her jaw from the welts. Received Rocephin and steroids'' in the ER. Recovered from the event shortly after.


VAERS ID: 1574579 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Laboratory test, Sensation of foreign body, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data: Unknown what medical test or laboratory test patient received.
CDC Split Type:

Write-up: Patient received Janssen Covid shot on 8/12/21 around 1:30pm and stated she noticed hives started to appear later that night. She claims when she was younger she used to get hives from unknown causes. She stated she didn''t think too much about it. The next day around 8 pm she said she noticed that the hives had gotten much worse. She also described a feeling of having a "ice cub" stuck in her throat and she was experiencing chest pain. She got worried and headed to Hospital Friday night (8/13/21). Prior to going to the hospital patient had administered claritin and ibuprofen before going to the hospital. At the hospital patient received prednisone, benadryl and famotidine. Patient was seen by practitioner which was supervised by Doctor.


VAERS ID: 1574604 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-30
Onset:2021-08-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Ear discomfort, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro Zyrtec Flonase Ezetimibe Saw Palmetto
Current Illness:
Preexisting Conditions: Anxiety High Cholesterol
Allergies: Clindamycin cephalexin
Diagnostic Lab Data: Doc checked my vitals and everything was fine
CDC Split Type:

Write-up: Dizziness Vertigo Nausea Ears feel full


VAERS ID: 1574664 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Heart rate decreased, Hypotension, Muscle spasms, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Transported to ER. Blood work normal. Released after about 5 hours in ER.
CDC Split Type:

Write-up: Severe muscle cramps then fainting. Low blood pressure (80/60) and heart rate (<50 bpm)


VAERS ID: 1574665 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Computerised tomogram, Cough, Dizziness, Headache, Nausea, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, Streptococcus test, Vision blurred, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol Cetirizine
Current Illness: Migraines/ hypertension
Preexisting Conditions: Recently rediagnoaed with hypertension and history of chronic migraines
Allergies: Rondec
Diagnostic Lab Data: As far as I was told all testing came back relatively normal and that It was probably just side effects from the vaccine to go home and sleep it off. Prescribed Phenergan for home nausea and to follow with pcp in 3 days
CDC Split Type:

Write-up: Fever, sore throat, vomiting. Nausea, dizziness, blurred vision, headache. Chest pain, cough Outpatient clinc and well as ER visit for treatment. Bloodwork, cheat xray, cat scan, strep test and covid swabbed


VAERS ID: 1575076 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-18
Onset:2021-08-14
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Imaging procedure abnormal, Portal vein thrombosis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknonwn
Preexisting Conditions: hypothyroidism endometriosis
Allergies: erythromycin, lamotrigine, bupropion
Diagnostic Lab Data: 8/14/21 finding of thrombosis of main portal vein and right portal vein thrombosis on imaging for abdominal pain
CDC Split Type:

Write-up: portal vein thrombosis


VAERS ID: 1575483 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cyanosis, Dyspnoea, Erythema, Fall, Foaming at mouth, Loss of consciousness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 3-4 minutes after receiving vaccine, the patient lost consciousness and fell face first on floor. The pharmacist on duty (myself) immediately evaluated the patient who was unresponsive and EMS was called. The patient was red/purple in the face, gasping for air and having difficulty breathing, and foaming at the mouth. Epinephrine 0.3mL was administered IM and the patient responded immediately. He was awake and alert until EMS arrive and transported him to the nearest hospital.


VAERS ID: 1575630 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cavernous sinus thrombosis, Coagulation test abnormal, Computerised tomogram head abnormal, Full blood count, Haemorrhagic transformation stroke, Metabolic function test, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Cavernous Sinus thrombosis and hemorrhagic conversion, low platelet


VAERS ID: 1575637 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Northern Mariana Islands  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram normal, Painful respiration, Pyrexia, Troponin I increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: An EKG was normal. DATE TIME SPECIMEN TEST VALUE Ref ranges ------------------------------------------------------------------------------- 08/15/2021 03:03 BLOOD TROP-I: 0.098 ng/mL .04 - 1.5 08/15/2021 00:42 BLOOD TROP-I: 0.139 ng/mL .04 - 1.5
CDC Split Type:

Write-up: Patient developed sudden onset fever, feeling of pressure on the chest, worse with inspiration, worse when laying down, better when standing up. The patient was given hyocyamine, famotidine, and tylenol and the fever and pain resolved. Three days later it has not recurred.


VAERS ID: 1577473 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-05-21
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Acne, Axillary pain, Biliary tract disorder, Chest pain, Cough, Culture, Immune system disorder, Injection site pain, Jaundice, Lymph node pain, Magnetic resonance imaging, Rash, Sinus congestion, Skin infection, Throat irritation, Urinary tract infection, White blood cell count
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EPIPEN; PREDNISONE; INSULIN
Current Illness: Alcohol use; Allergic reaction to antibiotics; Allergy to chemicals; Arthritis; Contrast media reaction; Diabetes mellitus insulin-dependent; Drug allergy; Non-smoker; Reaction to preservatives; Shellfish allergy
Preexisting Conditions: Comments: The patient had allergy of electrolytes water including magnesium sulphate. The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: MRI; Result Unstructured Data: not provided; Test Date: 202107; Test Name: Culture; Result Unstructured Data: colonization of some bacteria; Test Date: 20210805; Test Name: Culture; Result Unstructured Data: result awaited; Test Date: 20210805; Test Name: WBC; Result Unstructured Data: White blood cells in urine
CDC Split Type: USJNJFOC20210815103

Write-up: PAIN IN RIGHT ARMPIT; PAIN IN THE CHEST; COUGHING; MINOR SENSATION IN THROAT LIKE ITCHY; ENLARGEMENT OF EXTRAHEPATIC BILIARY DUCT; JAUNDICE; MUCUSY AND CONGESTION; IMMUNE RESPONSE; PAIN IN LYMPH NODE; INJECTION SITE STAB; URINARY TRACT INFECTION; SKIN INFECTION; RASH ALL OVER BODY; PUSTULES AND CLUSTERS OF PIMPLE ON FACE; This spontaneous report received from a patient concerned a 71 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: diabetic - insulin, sulfa allergy, arthritis, non smoker, rare alcohol use, contrast dyes allergy, crab/ cantaloupe allergy, preservatives allergy, allergy to statins, and polyethylene glycol 3350 allergy, and other pre-existing medical conditions included: The patient had allergy of electrolytes water including magnesium sulphate. The patient had no drug abuse or illicit drug usage. The patient experienced drug allergy when treated with lidocaine, Novocain (procaine hydrochloride), and Valium (diazepam). She visited an allergist on 19-MAY-2021, before vaccination (2 days before) because she has so many allergies and she was given an Epipen (epinephrine) and prednisone and continued taking it for 2 weeks. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: UNKNOWN) dose was not reported, 1 total administered on 21-MAY-2021 on left arm for prophylactic vaccination. Concomitant medications included insulin for diabetic-insulin. On 21-MAY-2021, five minutes after receiving her vaccine, developed rash all over her body and had to go to the emergency room where she was given a higher dose of steroid believed to be Prednisone. She stated that the rash lasted for 5 days, it felt like pustules and pimples, she describes it as clusters, but she continued taking her Prednisone. She also took Benadryl and Cortisone 5%. She was coughing and had pain in the chest. She was mucusy and congested. She felt that she also had internal reaction. She had minor sensation in her throat like itchy. When she left the hospital, she went to the gastroenterologist (GI doctor) they found a minor enlargement in the extrahepatic biliary duct, when she left from GI doctor she was all yellow and believed she had Jaundice. Her physician said she probably passed a gall stone. She had magnetic resonance imaging (MRI) a couple of weeks ago and she had a culture done. On JUL-2021, the patient had urinary tract infection and skin infection and was given antibiotics because the culture showed colonization of some bacteria. Laboratory data included: first culture (NR: not provided) colonization of some bacteria, and MRI (NR: not provided) not provided. On 05-AUG-2021, she had another test again and the physician found white blood cells (WBC) in her urine. Laboratory data included: WBC (NR: not provided) WBCs in her urine. She had another culture on 05-AUG-2021 and was still waiting on the results. Laboratory data included: second culture (NR: not provided) results awaited. She still has a pimple on her face but it was 99% resolved. Her issue now was with the pain she feels in her right armpit believed it was her lymph nodes. She described her pain as chronic. She believed that the vaccine might have caused some immune response. She was worried that her vaccine might not be effective because of the steroids she had to take. She felt a stab on the site of injection that lasted for 10 days. Treatment medications (dates unspecified) included: Benadryl (diphenhydramine hydrochloride), cortisone, and prednisone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from rash all over body on 26-MAY-2021, and injection site stab, was recovering from pustules and clusters of pimple on face, had not recovered from pain in right armpit, and pain in lymph node, and the outcome of coughing, minor sensation in throat like itchy, urinary tract infection, skin infection, enlargement of extrahepatic biliary duct, jaundice, pain in the chest, mucusy and congestion and immune response was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000188784. The suspected product quality complaint has been confirmed to be voided (reported complaints were adverse events, hence was confirmed as voided) based on the PQC evaluation/investigation performed.; Sender''s Comments: V0: 20210815103-JANSSEN COVID-19 VACCINE Ad26.COV2.S-Rash all over body. This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1577513 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Angina pectoris, Loss of consciousness, Troponin
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), Other ischaemic heart disease (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient was healthy
Allergies:
Diagnostic Lab Data: Test Name: Troponin; Result Unstructured Data: elevated troponin level
CDC Split Type: USJNJFOC20210827757

Write-up: BLACKED OUT UNCONSCIOUS IMMEDIATELY AFTER THE SHOT; SHOOTING PAIN IN HEART; This spontaneous report received from a patient via social media via a company representative concerned a 38 year old female. The patient''s height, and weight were not reported. Patient was healthy. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported,1 total, therapy start date was not reported for prophylactic vaccination. Batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient was blacked out unconscious immediately after the vaccination with shooting pain in heart. Patient was taken to the emergency room. Patient had elevated troponin levels. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the blacked out unconscious immediately after the shot and shooting pain in heart was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210827757-covid-19 vaccine ad26.cov2.s-blacked out unconscious immediately after the shot and shooting pain in heart. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1577517 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-05-07
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Dizziness, Joint swelling, Muscular weakness, Pain in extremity, Palpitations, Paraesthesia, Spinal pain, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: X-ray; Result Unstructured Data: Spine looked fine
CDC Split Type: USJNJFOC20210828922

Write-up: LITTLE SWOLLEN LEFT KNEE; CALF HURTING ON AND OFF; TINGLING IN BOTH FEET; WEAK PAINFUL LEGS; PAIN WORST IN THE LEFT LEG, LITTLE PAIN IN THE RIGHT LEG WHICH COMES BACK AND FORTH IN THE LAST COUPLE OF WEEKS BUT NOT AS THE LEFT LEG; PAIN MOVING UP FROM THE HIP TO CLOSE TO THE LEFT SIDE OF THE LOWER MIDDLE OF THE BACK, MOST PAIN WAS IN THE LEFT SIDE OF THE BACK; HEART RACING; PAIN IN RIGHT HIP WHICH WENT AWAY (DID NOT HURT ANYMORE) AND SWITCHED TO LEFT HIP AND WENT DOWN TO BOTH LEGS; LIGHT-HEADED; LOWER SPINE STARTED TO HURT WHICH WAS INITIATED BY THE SCIATIC NERVE AREA ON THE RIGHT HIP; This spontaneous report received from a patient concerned a 63 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-MAY-2021, the patient experienced lower spine started to hurt which was initiated by the sciatic nerve area on the right hip. On 14-MAY-2021, the patient experienced light-headed. On 05-JUN-2021, the patient experienced pain in right hip which went away (did not hurt anymore) and switched to left hip and went down to both legs. On 13-JUL-2021, the patient experienced heart racing. On 30-JUL-2021, the patient experienced pain moving up from the hip to close to the left side of the lower middle of the back, most pain was in the left side of the back. On 13-AUG-2021, the patient experienced pain worst in the left leg, little pain in the right leg which comes back and forth in the last couple of weeks but not as the left leg. On an unspecified date, the patient experienced little swollen left knee, calf hurting on and off, tingling in both feet, and weak painful legs. Laboratory data (dates unspecified) included: X-ray (NR: not provided) Spine looked fine. Treatment medications (dates unspecified) included: cyclobenzaprine hydrochloride. The action taken with covid-19 vaccine was not applicable. The patient recovered from lower spine started to hurt which was initiated by the sciatic nerve area on the right hip on 05-JUN-2021, had not recovered from pain in right hip which went away (did not hurt anymore) and switched to left hip and went down to both legs, pain moving up from the hip to close to the left side of the lower middle of the back, most pain was in the left side of the back, heart racing, and pain worst in the left leg, little pain in the right leg which comes back and forth in the last couple of weeks but not as the left leg, and the outcome of little swollen left knee, calf hurting on and off, light-headed, tingling in both feet and weak painful legs was not reported. This report was non-serious.


VAERS ID: 1577637 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: vasovagal response
Other Medications: FLUoxetine (PROzac) 10 mg tablet lamoTRIgine (LaMICtal) 25 mg tablet
Current Illness:
Preexisting Conditions:
Allergies: Prednisone - unspecified
Diagnostic Lab Data: Within 5 minutes pt became faint, asked to be placed on floor - then placed on stretcher - 5:05 B/P 113/75, heart rate 86, O2 Sat 97 5:10 B/P 110/75, heart rate 89, O2 Sat 98. 5:15 B/P 108/72, heart rate 89, O2 Sat 98
CDC Split Type:

Write-up: Pt came to vaccine clinic requesting J&J vaccine. Reviewed checklist that was completed by pt in clinic, on said checklist pt checked NO in response to "Have you ever received a dose of COVID-19 vaccine?" Pt''s name clicked in system, notice flashed in red that pt not due for vaccine of J&J due to inappropriate at this time. ?Pt. Questioned by me, states this is first vaccine. ?Pt states she gets vasovagal response and fainting feeling to needles and shots in the past, pt placed into blue easy chair in the clinic to prevent injury in the event pt has vasovagal response as described. ?J&J vaccine administered with second RN in attendance. ?Within 5 minutes pt became faint, asked to be placed on floor - then placed on stretcher - Vitals B/P 113/75, heart rate 86, O2 Sat 97 at 5:05. ?Public response called at 5:03 PM, evaluated by ED team and found to be stable. ?Pt. Questioned about receiving a prior covid vaccine, pt first stated today''s vaccine was her first; upon further questioning pt states she received a pfizer vaccine months ago but could not remember when. ?Pt. States she took the vaccine today because she was afraid that she would have to restart pfizer vaccine series again and would not have it in time to get into school classes, so she decided to get J&J vaccine today. Pt advised by Staff on possible side effects of vaccine and to go to ED if experiences same. ?Pt advised Staff will call her via phone tomorrow 8-12-21 and 8-13-221 to check on her and how she is feeling. ?Pt agreeable to same. 5:10 B/P 110/75, heart rate 89m O2 Sat 98. 5:15 B/P 108/72, heart rate 89. ?O2 Sat 98 Pt discharged via WC with friend who will drive her home.


VAERS ID: 1577841 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-07
Onset:2021-08-16
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Decreased appetite, Diarrhoea, Fall, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED on 8/16/21 for a 5 day history of nonproductive cough and anorexia. Over the past two days he developed fevers, generalized weakness and non-bloody diarrhea. Had two falls prior to hospital admission due to weakness. No prior COVID-19 infections but tested positive upon arrival to the hospital. COVID-19 vaccination received July 7, 2021. Not requiring oxygen at time of admission, saturations $g94%.


VAERS ID: 1577861 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-27
Onset:2021-08-16
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dysstasia, Fall, Joint injury, Pain, SARS-CoV-2 test positive, Somnolence, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypoglycaemia (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: He comes to the hospital today after sustaining a fall. Information from the ER physician is that the patient states he was getting out of bed, slipped onto his left hip and was unable to stand up again secondary to the pain and was on the floor for a prolonged amount of time. Eventually EMS was called and brought the patient to the emergency department. He is a very poor historian when I evaluated him in the emergency department. In fact he was fairly somnolent, he did have some morphine earlier. He would open his eyes but just mumbled answers to my questions. He was able to tell me who he was, where he was, and what year it was, and that he hurt his left hip but other than that he was really not able to give any other information with regards to his HPI. I told him that he was positive for Covid, asked him if he had any respiratory symptoms and he denied. I asked him if he knew how he contracted it and he shook his head no.


VAERS ID: 1577930 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-28
Onset:2021-04-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Lymphadenopathy, Mammogram, Neoplasm malignant, Ultrasound Doppler
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins multi
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Mammogram and ultrasound. 8/1/2021
CDC Split Type:

Write-up: I have had a Severe period with extra heavy clots that has not stopped since the shot. As well I have all swollen lymph nodes in my arm pits and breasts and suspicious cancer is now appearing in several areas of my breasts.


VAERS ID: 1578060 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-08-13
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No known home medications
Current Illness: unknown
Preexisting Conditions: Denies
Allergies: No known allergies
Diagnostic Lab Data: Patient initially tested positive for COVID infection on 08/05/21, per history, type/place unknown
CDC Split Type:

Write-up: The patient presents with shortness of breath. 56 year old male presents to ED complaining of sob, secondary to COVID-19 infection. Pt reports his O2 saturation drooped to 85% PTA. He discussed this concern with his PCP, who advised him to visit the ED. Pt is COVID-19 positive. PT PRESENTS TO ED FROM HOME VIA EMS FOR CO SHORTNESSOF BREATH. PT TESTED POSITIVE FOR COVID A WEEK AND A HALF AGO. PT WAS AT 87% ON RA UPON EMS ARRIVAL. when pt arrived to the ED he was placed on 4L NC and his sat was 88%.


VAERS ID: 1578099 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-03
Onset:2021-08-15
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anticoagulant therapy, Atrial fibrillation, Blood test, Chest X-ray, Dyspnoea, Electrocardiogram, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Multiple EKGs (8/15/21 & 8/17/21), chest x-ray and blood tests 8/15/21
CDC Split Type:

Write-up: Diagnosis - atrial fibrillation Treatment - asprin Symptoms - 8/15/2021 9:30 p.m. shortness of breath, heart palpitations. aFib seized 8/16/2021 at 6:30 a.m.


VAERS ID: 1578137 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Chest pain, Chills, Decreased appetite, Haematemesis, Hypoaesthesia oral, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, chest pain, stomach pain, weakness, site pain, nausea, loss of appetite, numbness of the tounge, throwing up blood


VAERS ID: 1578196 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dysphagia, Erythema, Feeling hot, Interchange of vaccine products, Migraine, Myalgia, Nausea, Peripheral coldness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: Alleric reaction requiring hospitalization. Age 23. Moderna COVID-19 mRNA Vaccine on 03/08/2021.
Other Medications: Zenatane 40mg twice daily. Pepcid 20mg once prior to vaccination. Diphenhydramine 25mg once prior to vaccination.
Current Illness:
Preexisting Conditions:
Allergies: Latex, Compizine, Morphine, Guanfacine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient arrived for COVID-19 vaccination at 14:30 on 08/16/21. Patient had previous serious reaction to Moderna COVID-19 mRNA Vaccine on 03/08/2021 requiring hospitalization. CDC guidelines for use of Janssen COVID-19 vaccine following allergic reaction to mRNA vaccine was utilized. Patient pre-medicated with Pepcid 20mg and diphenhydramine 25mg prior 30 minutes prior to arrival at the pharmacy and the patient''s mother was present. Epi-pen was on hand as well. After recieving the vaccine, patient reported nausea and cold extremities. Patient developed erythema on the chest, back and throat. Patient reported feeling "hot" and experienced diarrehea. Patient reported difficulty swallowing and was transported to ER for further treatment. Epi-pen was not utilized in pharmacy, and patient''s time in the pharmacy was approximately one hour before transit to ER. Patient reported via text message experiencing muscle pain and a migraine. Patient was stable at Hospital and reported receiving diphenhydramine, promethazine, methylprednisolone, magnesium, epinephrine, Toradol, and IV fluids. Patient is currently hospitalized at the time of this report (one day later). Patient was NOT contacted by the VAERS system previously regarding her adverse event on 03/08/2021 with the Moderna COVID-19 mRNA vaccine. Patient''s VAERS for that event is 1247355. I submitted two reports regarding that adverse event.


VAERS ID: 1578304 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Myocardial infarction, Pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: per patient - "08/13/2021 pressure in chest started throwing up and a lot of pressure. a log of sharp pains. went to hospital and was diagnosed as heartattack."


VAERS ID: 1578306 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Ophthalmic herpes zoster
SMQs:, Ocular infections (narrow), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Augmentin
Diagnostic Lab Data: Unsure what tests were conducted. Seen and diagnosed on Monday 16 August 2021, at Optometry Clinic at approximately 1245pm. Patient was deployed the next day. Outcome unknown at this time.
CDC Split Type:

Write-up: Herpes Zoster Ophthalmicus to the left eye. Given 7-day course of Valacyclovir, two types of eye drops and an eye ointment. Patient was deployed the next day. Outcome unknown at this time.


VAERS ID: 1578311 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: PATIENT RECEIVED VACCINATION AND SAT DOWN FOR HER 15 MINUTE WAIT. WITHIN 5 MINUTES PT WAS VERY LIGHT HEADED, HAVING TROUBLE BREATHING (NOT DUE TO SWELLING), AND PINS AND NEEDLES IN HER HANDS


VAERS ID: 1578320 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-26
Onset:2021-05-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood heavy metal normal, Blood test, Blood thyroid stimulating hormone, Computerised tomogram head, Differential white blood cell count normal, Epstein-Barr virus test positive, Fatigue, Fibrin D dimer decreased, Full blood count normal, Hallucination, Headache, Hydroxyproline, Immunology test, Metabolic function test normal, Photophobia, Platelet count normal, Pyrexia, Vision blurred, Vitamin D
SMQs:, Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot, was sick for a few days
Other Medications: Omeprozole
Current Illness: GIRD
Preexisting Conditions: GIRD
Allergies: Penicilin
Diagnostic Lab Data: 06/03/21: The following blood tests were done at Lab: TSH+Free T4: normal CBC With Differential/Platelet: normal Comp. Metabolic Panel (14): normal Vitamin D, 25-Hydroxy: 24.9 - low D-Dimer: <.20 - normal 06/20/21: Emergency Room visit. CT scan of head was done, no clotting found. Test for Lymes disease was done 07/06/21: Infection specialist was seen. Re-tested for Lymes which came back negative. Tested for antibodies for Epstein-Barr came back positive. 07/15/21: At Lab, the following test was done: Heavy Metals Profile II, Blood. Results were normal
CDC Split Type:

Write-up: Fever and hallucinations on first night after dose. From injection onwards constant headache and eye issues such as focusing and photophobia, fatigue, tiredness.


VAERS ID: 1578391 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Condition aggravated, Heart rate irregular, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiac arrhythmia terms, nonspecific (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: EMPLOYEE WAS VACCINATED ON 8/11/21 AND DEVELOPED irregular heart beats, and tachycardia. PATIENT WENT TO HOSPITAL DUE TO IRREGULAR HEART BEAT AND TACHYCARDIA. PATIENT HAS A MEDICAL HISTORY OF PVS''S AND IRREGULAR HEART BEAT.


VAERS ID: 1578450 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: 5 minutes after giving JJ vaccine. Patient came to counter and said he needed to lie down bc he was feeling faint. I instructed him to lie down and by the time I got to him he had fainted. He was out for a few seconds. He remained lying down and felt dizzy. But was uninjured.


VAERS ID: 1578465 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-06-10
Onset:2021-06-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / N/A - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood alkaline phosphatase increased, Computerised tomogram head normal, Full blood count, Headache, Metabolic function test, Nausea, Pain
SMQs:, Liver related investigations, signs and symptoms (broad), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: BMP and CBC-- $g alkaline phosphatase = 198.
CDC Split Type:

Write-up: Patient experiences throbbing headache, body aches and nausea. CT head is within normal limits. Patient is treated with IV fluids, IV acetaminophen and ondansetron.


VAERS ID: 1578526 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-08-17
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

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

Write-up: Three weeks of thick congestion in chest. Runny nose, initially sore throat


VAERS ID: 1578587 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-08-11
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Feeling abnormal
SMQs:, Dementia (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Methylphenidate ER 27 MG at the time of vaccine. Increased to 36 MG the following month
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/11/2021 ER Visit with examination by multiple RN. CT Scan to rule out other diagnosis read by MD radiologist.
CDC Split Type:

Write-up: Bell''s Palsy and Mental fog


VAERS ID: 1578989 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Differential white blood cell count, Fibrin D dimer, Full blood count, Magnetic resonance imaging head, Seizure, Troponin, Urine analysis
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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Due to clotting fears my er visit on the 26th has a lot. cbc diff er troponin ua /micro whole blood lactate d-dimer chest xray mri brain with and without contrast
CDC Split Type:

Write-up: 6 days after the vaccine I began to develop seizures. I had no previous signs, symptoms or seizures before this. The first time I went to urgent care. I also went to an ER. I have also visited a neurologist and a epileptologist.


VAERS ID: 1579192 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-06
Onset:2021-08-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, SARS-CoV-2 test negative, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control Cetirizine Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid test 8/11/21: negative
CDC Split Type:

Write-up: Hives from scalp all over body to in between toes. Per allergist request, started with up to 4 cetirizine a day to prevent itching. After two days, hives were worse and itching more so started on prednisone 40mg for 5 days and famotidine 20mg twice daily. Over the course of a week after the hives started, they started to go away but then would show up randomly all over body again and continued to itch.


VAERS ID: 1579199 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Colonoscopy, Computerised tomogram, Gynaecological examination, Tearfulness, Ultrasound scan vagina, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Probiotic, Vitamin C, Zinc and Magnesium
Current Illness:
Preexisting Conditions: Celiac Disease
Allergies: Gluten intolerant, lactose intolerant, corn intolerant
Diagnostic Lab Data: X-Ray Intravaginal Ultrasound CT Scan Colonoscopy Pelvic Exam
CDC Split Type:

Write-up: I experienced abdominal pain about a half hour after receiving the shot. For the next two weeks the pain would come and go but was never totally gone. Some days were worse than others. On April 13th the pain was severe enough by 6:00pm that I knew something was wrong. By 7:00pm I was in tears the pain was so bad. I was vomiting, in pain, bloated, so much pain it was debilitating. I have a history of bowel obstructions and ovarian cysts and usually fight going to the hospital as long as I can and also refuse pain meds. But this was the worst pain I have ever felt and I was begging for morphine by the time we got to the hospital. After 7 hours, I left the ER still in pain and without any answers. I followed up with an obgyn, GI, colonoscopy, my primary. There was no answer as to what happened. I''m still having pain and bloating without warning.


VAERS ID: 1580107 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-08-08
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Hypoaesthesia, Influenza like illness, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (minimal amount); Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Marijuana use (Not for a very long time.); Comments: The patient takes birth control but was perfectly healthy. The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210830339

Write-up: RIGHT ARM FEELS LIKE IT WAS COMPLETELY ASLEEP TRIED TO PUT WEIGHT ON IT AND COLLAPSED; NAUSEOUS; TINGLING FINGER TIPS, HANDS AND FEET; FINGER TIPS FEELING LITTLE NUMB/RIGHT ARM FEELS LIKE IT WAS COMPLETELY ASLEEP; FLU-LIKE SYMPTOMS; This spontaneous report received from a patient concerned a 20 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: marijuana use, and concurrent conditions included: alcohol use, and non-smoker, and other pre-existing medical conditions included: The patient takes birth control but was perfectly healthy. The patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A expiry: UNKNOWN) dose was not reported, administered on 08-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-AUG-2021, the patient experienced flu-like symptoms. On 11-AUG-2021, the patient experienced tingling finger tips, hands and feet. On 11-AUG-2021, the patient experienced finger tips feeling little numb/right arm feels like it was completely asleep. On 13-AUG-2021, the patient experienced nauseous. On 14-AUG-2021, the patient experienced right arm feels like it was completely asleep tried to put weight on it and collapsed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu-like symptoms, had not recovered from tingling finger tips, hands and feet, finger tips feeling little numb/right arm feels like it was completely asleep, and right arm feels like it was completely asleep tried to put weight on it and collapsed, and the outcome of nauseous was not reported. This report was non-serious.


VAERS ID: 1580109 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-08-04
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Contusion, Headache, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No known drug abuse or illicit drug usage, alcohol usage or smoking
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210830345

Write-up: BRUISING; NUMBNESS IN LEFT SIDE; TINGLING IN LEFT SIDE; WEAKNESS; HEADACHE; This spontaneous report received from a consumer concerned a 47 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: No known drug abuse or illicit drug usage, alcohol usage or smoking. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286, expiry: 24-OCT-2021) dose was not reported, administered on 04-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-AUG-2021, the patient experienced bruising. On 04-AUG-2021, the patient experienced numbness in left side. On 04-AUG-2021, the patient experienced tingling in left side. On 04-AUG-2021, the patient experienced weakness. On 04-AUG-2021, the patient experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tingling in left side, weakness, headache, bruising, and numbness in left side. This report was non-serious.


VAERS ID: 1580115 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-30
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Dysgeusia, Fatigue
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CALCIUM;COLECALCIFEROL; VITAMIN C [ASCORBIC ACID]
Current Illness: Alcoholic (Once weekly); Allergy multiple; Food allergy; Non-smoker; Pollen allergy
Preexisting Conditions: Comments: No medical disorder. Patient reported no drug abuse or illicit usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210830508

Write-up: BRUISE ON RIGHT FOREARM; TIREDNESS; SENSATION OF TONGUE COATED IN SALT; This spontaneous report received from a patient concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: pollen allergy, allergies nos, food allergy, alcoholic, and non smoker, and other pre-existing medical conditions included: No medical disorder. Patient reported no drug abuse or illicit usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 30-JUL-2021 for prophylactic vaccination. Concomitant medications included ascorbic acid, and calcium/colecalciferol. On 30-JUL-2021, the patient experienced sensation of tongue coated in salt. On 31-JUL-2021, the patient experienced tiredness. On AUG-2021, the patient experienced bruise on right forearm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tiredness on 31-JUL-2021, and had not recovered from bruise on right forearm, and sensation of tongue coated in salt. This report was non-serious.


VAERS ID: 1580117 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-13
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Neurological examination; Result Unstructured Data: Decreased sensation on right foot compared to the other one
CDC Split Type: USJNJFOC20210832358

Write-up: PERSISTENT NUMBNESS IN RIGHT FOOT; This spontaneous report received from a physician concerned a 51 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: 21-SEP-2021) dose was not reported, administered on 13-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, Laboratory data included: Neurological examination (NR: not provided) Decreased sensation on right foot compared to the other one. On 13-AUG-2021, the patient experienced persistent numbness in right foot. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from persistent numbness in right foot. This report was non-serious.


VAERS ID: 1582142 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Apnoea, Asthenia, Injection site pain, Loss of consciousness, Malaise, Nausea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Nausea-Medium, Systemic: Weakness-Severe, Additional Details: Post vaccine: 2 min after the vaccine pt reports that she is not feeling well. Pt transferred to the exam table safely. Pt lost consciousness, became apneic, and carotid pulse not palpable. Two chest compressions were given and pt gained her consciousness. 911 activated. Pt returned to normal state and denies any s/s. Pt reports that she was scared of the needle and that she had mild pain in her injection site and she panicked. She reports that she has had multiple similar events in the past.


VAERS ID: 1582293 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-11
Onset:2021-08-06
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Pain in extremity, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo Loestrin Fe
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Doppler ultrasound (08/11/2021)
CDC Split Type:

Write-up: Pain noticed in right calf (8/6/21). Pain got worse and prompted ER visit. Blood clot diagnosed in right leg/calf area via Doppler ultrasound (8/11/21). Eliquis prescribed for three months minimum and compression sleeve to be worn daily.


VAERS ID: 1582326 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-06
Onset:2021-08-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Burning sensation, Dehydration, Fatigue, Headache, Pyrexia, Rash, Vomiting, Weight decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Spironolactone, Levothryroxine, Cranberry Pills
Current Illness: None
Preexisting Conditions: Hypothyroidism, anxiety, depression.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: vomiting, headache, high fever, rash, burning sensation all over body, fatigue, weakness, weight loss, dehydration, had to get IV fluids on 3 separate occasions.


VAERS ID: 1582385 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-25
Onset:2021-06-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Laboratory test, Magnetic resonance imaging, Neurological symptom, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril, Amlodopine, Atorvastatin, Pantaprazole, Plavix, CoQ10, Vit D3, Vit K2, Probiotic
Current Illness:
Preexisting Conditions: High blood pressure, high cholesterol, stroke survivor (5 yrs).
Allergies:
Diagnostic Lab Data: I can provide copies of all hospital MRI & lab tests.
CDC Split Type:

Write-up: June 24, 2021 approx 4pm, called 911 for stroke symptoms. Admitted to hospital l for 1 wk then discharged to Rehab. An unknown rash also developed on June 27/28 all over his back & cleared up approx 5 days later without treatment.


VAERS ID: 1582397 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-07-31
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A27A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: tingling, rash developed into shingles


VAERS ID: 1582404 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-05-21
Onset:2021-06-14
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Electrocardiogram abnormal, Troponin
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Abilify 2 mg oral tablet, 2 mg, 1 tab, PO, daily Cymbalta 60 mg oral delayed release capsule, 60 mg, 1 cap, PO, daily gabapentin 600 mg oral tablet, 900 mg, 1.5 tab, PO, TID lisinopril 40 mg oral tablet, 40 mg, 1 tab, PO, daily traZODone 50
Current Illness: None
Preexisting Conditions: HTN Depression Provoked DVT Chronic pain Factor 5 Leiden heterozygous
Allergies: None
Diagnostic Lab Data: EKG 6/17/21 Troponin 6/17/21
CDC Split Type:

Write-up: STEMI 6/17/21


VAERS ID: 1582450 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-03
Onset:2021-07-19
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test abnormal, COVID-19, Cholecystitis, Cholecystitis infective, Colostomy, Feeling cold, Gastrooesophageal reflux disease, Infection, Malaise, Pain, Pyrexia, SARS-CoV-2 test positive, Thrombosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Mutliple vitamin, prebiotics and probiotics.
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Codeine
Diagnostic Lab Data: Covid-19 four times Three were negative in which the fourth one was positive. 07/28/2021,07/29/2021, 08/01/2021 08/03/2021
CDC Split Type:

Write-up: On 07/03/2021 Patient was administered a Johnson & Johnson Covid-19 sot in his right arm at 12:43p.m. Everything went well as far as the shot went,but as time went on 07/19/2021 he was waken at 5:30 a.m. a bad case of acid reflux which he had awhile ago but not since he was taking prebiotics and probiotics which helped but not this time it came with a vengeance. He was vomiting and had a fever. He did take some Omeprazole that morning which it stop for a while but the moment he went to eat some food it started all over again the vomiting and the fever was back higher then before. By Wednesday 07/28/2021 it was better bad so we went over to a Medical Center they then took a Coivd-19 Test which was negative. They did ran a battery of blood work on him but after waiting for five long hours to be seen by a doctor he was extremely cold in the waiting area and he was in great pain sitting on the uncomfortable chairs we went home. The following day we went over to urgent care and once again the PA give him another Covid-!9 test which was once again negative The PA suggested we go over to a Hospital. The next day we went over there was tested again and was negative again They checked him in but they never found the Covid-19 after being poked and stuck soo many times he was really not feeling good and they did know that he had a inflamed and infected gallbladder which the infection traveled through his blood stream Which was very dangerous for him however it appeared that they were taking his blood every two hours which became very unbearable for him and he wanted to go home. I went to pick him up at 3:00 a.m. One of the call me to convince to still in the hospital but he refused. So the next day we went over to another Hospital, Their was when he tested postive all because his gallbladder was very inflamed and infected due to the vaccine and he also has a blood clot thats on top of his liver.Now he has to wear a colonscopy bag until they can remove his gallbladder which is about four weeks . He has to wear the bag to drain any infection . They have him taking A blood thinner Drug which was $645.93 which we can''t afford.


VAERS ID: 1582487 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: Slight lip swelling noted 5 min after vaccine adm. Doctor informed, rec''d advise to have pt transfer to urgent care. Pt in stable condition, no respiratory distress.


VAERS ID: 1582557 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Lip haemorrhage, Lip injury, Skin abrasion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: The patient fainted and fell after 10 minutes of injection according to the observation staff. The patient became alert and oriented immediately when I got to her side. The patient was talking and said she felt fine. Vitals: 110/72, pulse 56. The patient was positioned in supine with pillow under her head. Applied cold water towel on her forehead. She was then able to sit up and stand without any problem after 5 minutes of observation on the floor. The bleeding from the superficial split lower lip stopped immediately with gauze pressure. A superficial abrasion on the left knee was not bleeding. There was no bleeding lesion on other area of the face or the head. The patient was evaluated by medics by calling 911 upon patient husbands request .


VAERS ID: 1582623 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-03
Onset:2021-07-01
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043421A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Confusional state, Dizziness, Electrocardiogram normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I have had an CT scan, EKG and blood work, all results were normal. I am no also seeing an acupuncturist.
CDC Split Type:

Write-up: I am experiencing dizziness and confusion at times. It has been constant for over a month and is worse when I look up to the left or lay down.


VAERS ID: 1582703 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-13
Onset:2021-08-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)

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

Write-up: tingling in legs (mild), sharp pain inside of elbow, arm tingling


VAERS ID: 1582717 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2020A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Feeling abnormal, Feeling jittery
SMQs:, Dementia (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: Vitamin C+D with Zinc
Current Illness: None
Preexisting Conditions: Denies
Allergies: NKA
Diagnostic Lab Data: Possibly EKG in ED
CDC Split Type:

Write-up: 8/17/2021 at 1210, approximately 10 mins post vaccination, reported feeling jittery "I feel like I''m running" . VS checked: BP 129/80, HR fluctuates between 112-120 bpm. RR 12-20. Oxygen Sat 96% on RA. Denies CP, Palpitations, SOB, light headedness, HA. Symmetrical smile, No c/o of extremity weakness. transported to ED for further obseravation.


VAERS ID: 1582751 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling cold, Headache, Hypoaesthesia, Pain, Paraesthesia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Patient was seen at ER on 8/14/21
CDC Split Type:

Write-up: See below notes for dos 8/17/21: Patient presents today stating that on 8/13 she began with numbness and tingling in both hands and feet. No paralysis. She had facial numbness and could feel it in the back of her throat. She was able to swallow and chew okay. No facial droop or blurry vision. She did have a headache, but not a migraine. The next day all her symptoms were still present so she went to ER. Labs were normal than. She states that she now having more muscle weakness, mostly in her legs, but some in her arms. She still has numbness in her feet and in her hands, but the tingling is gone. The facial numbness/tingling is improved. She still has some R sided facial numbness, but she has had this before. No headache now. She recently had the J&J COVID vaccine on 8/10 at Pharmacy. She denies any hx of reaction to vaccines in the past. She states that on 8/13 she had some SOB with vacuuming on 8/13, but she hasn''t noticed any SOB since 8/13, but she has been resting. She does note some feelings of being off balance, but denies falls. She had chills, fever, and body aches after the COVID for 48 hours.


VAERS ID: 1582813 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-03
Onset:2021-04-20
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fibrin D dimer increased, Injection site hypoaesthesia, Laboratory test
SMQs:, Haemorrhage laboratory terms (broad)

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

Write-up: I went to work to numbness in my left arm, where I received the vaccine. The numbness did not go away, so my boss recommended I go to urgent care, due to the Johnson and Johnson vaccine being in the news for causing blood clots. I went to urgent care, the APNP took some blood samples to be safe. The D-Dimer came back abnormal, so she recommended I go to the emergency room immediately. I then went to the emergency room where they took multiple test. Luckily there was not a blood clot at that time, but it costed my more than $4,000 due to get the vaccine. I have not had abnormal blood samples before, plus was had a physical through my work and scored 99 out of 100 for my health.


VAERS ID: 1582900 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported becoming hot and dizzy within a few minutes of receiving the vaccine. She was escorted to the ED via stretcher.


VAERS ID: 1582935 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-30
Onset:2021-08-16
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive
SMQs:, 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Case developed symptoms and tested positive for COVID19.


VAERS ID: 1582958 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-08
Onset:2021-08-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood electrolytes, Blood test, Chest discomfort, Dizziness, Headache, Muscular weakness, Paraesthesia, Thyroid function test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 8/14 Emergency room visit. Vitamins, minerals, electrolytes, and thyroid were checked via a blood test.
CDC Split Type:

Write-up: Tingling in hands, arms, and feet. Weakness in right arm. Dizziness, headache, chest tightness.


VAERS ID: 1582978 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-09
Onset:2021-08-01
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Chills, Diarrhoea, Dyspnoea, Fatigue, Nausea, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: HYPERTENSION, CHRONIC LUNG DISEASE (COPD), ASTHMA AND FORMER SMOKER
Allergies: UNKNOWN
Diagnostic Lab Data: MOLECULAR AMPLIFICATION TEST RT PCR POSITIVE FOR SARS-COV-2
CDC Split Type:

Write-up: VACCINATED WITH JANSSEN VACCINE IN MARCH OF THIS YEAR. WENT TO HOSPITAL ER ON 8/15/21 WITH A 2 WEEK HISTORY OF SYMPTOMS WHICH INCLUDED: CHILLS, RUNNY NOSE, FATIGUE, SHORTNESS OF BREATH, NAUSEA, ABDOMINAL PAIN AND DIARRHEA. RECEIVED MONOCLONAL ANTIBODY TREATMENT WHILE IN ER AND WAS ADMITTED THE SAME DAY. SHE IS NOT IN ICU OR ON THE VENTILATOR. HER HUSBAND TESTED POSITIVE ON 8/6/21 AND HE WAS HOSPITALIZED ON 8/14/21.


VAERS ID: 1583359 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Electrocardiogram, Postictal state, Seizure
SMQs:, Systemic lupus erythematosus (broad), Supraventricular tachyarrhythmias (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium daily furosemide 40 mg tablet TAKE ONE TABLET BY MOUTH ONE TIME DAILY L-Lysine 500 mg tablet Take 1 tablet every day by oral route. melatonin 2 tablets at HS omeprazole 20 mg capsule,delayed release TAKE ONE CAPSULE BY MOUTH
Current Illness: none reported
Preexisting Conditions: COPD Chronic Kidney Disease Renal Bone Disease Hypertension
Allergies: NKDA Reports historically reaction to eggs but no longer
Diagnostic Lab Data: EKG and transport to ED.
CDC Split Type:

Write-up: Patient was given vaccine after completing consent and Prevaccination Checklist for COVID-19 vaccines. Provider was in room with patient after vaccine. Provider reports patient stood from bed and moved to chair. Provider reports patient had a seizure that lasted 4 minutes per provider and a 10 minute postical phase. Provider palpated heart rate and reported patient went in to afibrilation. EKG was performed and ambulance called. Patient transported to ED.


VAERS ID: 1583617 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: urticaria, induration at injection site, tingling of mouth
Other Medications: Pt was given 50 mg of Benadryl prior to vaccination per her request due to problems with influenza vaccination and Dtap vaccinations in the past.
Current Illness: none
Preexisting Conditions:
Allergies: Nortriptyline, influenza and Dtap vaccinations.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 minutes after administered vaccine, pt reports having tightness in her throat and some tingling in her mouth. She was escorted to the ER. When arrived at the ER she reported slight shortness of breath.


VAERS ID: 1583832 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-03-01
Onset:2021-04-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Condition aggravated, Dysphagia, Hypertension, Laboratory test, Oesophageal dilatation, Oesophagoscopy, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), 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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: Swine flu vaccine in 1976
Other Medications: Atenolol, Simvastatin, Omeprazole, aspirin, vitamin D3, calcium
Current Illness: None
Preexisting Conditions: Cancer, gerd, a-fib, asthma
Allergies: Cephalosporins, metoprolol, cipro, shellfish, Proventil, Bactrim, albuterol morphine
Diagnostic Lab Data: 4 trips to the ER, several labs, esophageal scope with dilation
CDC Split Type:

Write-up: Ringing in ears, high blood pressure, atrial fib episodes, swallowing problems


VAERS ID: 1584017 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-30
Onset:2021-08-11
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anion gap increased, Atrial fibrillation, Blood chloride increased, Blood potassium decreased, Blood sodium increased, Chest X-ray normal, Differential white blood cell count abnormal, Electrocardiogram abnormal, Full blood count abnormal, Haemoglobin normal, Heart rate irregular, Limb discomfort, Metabolic function test, Myocardial necrosis marker normal
SMQs:, Haematopoietic leukopenia (broad), Lactic acidosis (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Dehydration (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metamucil
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG- Atrial fibrillation CBC diff - abnormal results Hgb 15.4, BMP - Sodium 148, Potassium 3.3, Chloride 107, Anion Gap18 - Physician''s did not think these labs were that abnormal to cause Atrial fibrillation Chest x-ray normal Cardiac enzymes within normal limits
CDC Split Type:

Write-up: Woke up with irregular heat beat and just felt like legs and arms were heavy. Put watch on and heart rate at 130 beats/minute. Went to ER and was found to be in atrial fibrillation. Spent 4 hours in the ER. Heart rate slowed to the 70''s-80''s but remained in atrial fibrillation. Lovenox given and a prescription for apixaban 5mg twice daily.


VAERS ID: 1584019 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-01
Onset:2021-08-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram, Computerised tomogram abdomen, Computerised tomogram head, Computerised tomogram thorax abnormal, Fatigue, Malaise, Mobility decreased, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan/Hctz 50/12.5 mg tablets, vitamin D3, and Tylenol
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I was instructed by the doctor to take my mom to the ER on August 13, because she had not been feeling well. The ER doctor order CT scans on her head, chest, stomach, and lower back. They told me she had a blood clot in her lung. My mom said since the vaccine she has slowed down, walking less because she felt tired all the time. She was released on August 16 from the hospital and currently on blood thinner for the next 3 months.
CDC Split Type:

Write-up: My mom said she didn''t feel the same after the vaccine. On July 25 she started a new medication and had side effects to it. She was recently in the hospital on August 13 and they said she had a blood clot in her lung.


VAERS ID: 1586344 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-24
Onset:2021-05-08
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Chest pain, Gait disturbance, Groin pain, Muscle spasms, Oropharyngeal pain
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 8/16/21 diagnosed with VITT and EBV release due to vaccine
CDC Split Type:

Write-up: Severe cramps in legs, chest, throat, chronic pain in and stiffness in lower joints. Shooting pain in groin. unable to walk correctly and keep balance


VAERS ID: 1586644 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-04
Onset:2021-08-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Muscle disorder, Pain
SMQs:, Rhabdomyolysis/myopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen, baby ASA, duloxetine, ezetimibe, benefibrate, HCTZ, levothyroxine, lisinopril, metformin, metoprolol, pravastatin
Current Illness: NO
Preexisting Conditions: Type 2 DM, hypercholeserolemia, HTN, hypothyroidism, nerve pain (right shoulder/neck/right hip)
Allergies: N/A
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: Visit to ED for pain medication - prescribed Hydrocodone 5/325 Return visit to PCP for muscle relaxant - cyclobenzaprine 10 mg TID PT


VAERS ID: 1586804 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-12
Onset:2021-08-11
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole (PRILOSEC) 20 mg capsule TAKE 1 CAPSULE (20 MG) BY MOUTH 2 TIMES A DAY BEFORE MEALS Phytonadione, vitamin K, 100 MCG TABS tablet Take 1 tablet (100 mcg) by mouth 1 time per day warfarin (JANTOVEN) 5 mg tablet TAKE 1 TO 1&1/2 TABS
Current Illness: none
Preexisting Conditions: CAD (coronary artery disease) Thrombus of left atrial appendage without antecedent myocardial infarction Typical atrial flutter Presence of drug coated stent in right coronary artery Abnormality of left atrial appendage OSA (obstructive sleep apnea) Obese Dyslipidemia Diabetes mellitus Fuchs'' corneal dystrophy History of ST elevation myocardial infarction (STEMI) Long term (current) use of anticoagulants
Allergies: NKA
Diagnostic Lab Data: positive covid-19 test on 8/16/21
CDC Split Type:

Write-up: patient developed covid-19 infection on 8/11/21. positive test 8/16/21


VAERS ID: 1586835 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-08
Onset:2021-08-16
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Influenza like illness, Malaise, Pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 PCR test done on 8/16/21, reported positive.
CDC Split Type:

Write-up: Patient admitted to facility for shortness of breath and cough for several days. Patient stated that they have had flu-like symptoms for 2 weeks. Patient also stated to have malaise, congestion, and body aches.


VAERS ID: 1586843 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-07-17
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head, Diplopia, Eye pain, Gaze palsy, Giant cell arteritis, Microvascular cranial nerve palsy, Paranasal sinus discomfort
SMQs:, Glaucoma (broad), Optic nerve disorders (broad), Vasculitis (narrow), Ocular motility disorders (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1) ATORVASTATIN CALCIUM 20MG TAB TAKE ONE TABLET BY ACTIVE MOUTH ONE TIME EACH DAY FOR CHOLESTEROL **WHOLE TABLETS APPROVED** 2) CONTACT LENS CLEANING (CLEAR CARE) SOLN USE A SMALL ACTIVE AMOUNT AT BEDTI
Current Illness:
Preexisting Conditions: Osteoarthritis (SCT 396275006) Vitamin D Deficiency (SCT 34713006) Polyp of colon (SCT 68496003) Obstructive sleep apnea of adult (SCT 1101000119103) Hyperlipidemia (SCT 55822004) Umbilical hernia (SCT 396347007) Ulcer, Central Cornea Allergic rhinitis (SCT 61582004) Knee pain (SCT 30989003) Impaired fasting glucose (SCT 390951007) Hypothyroid (SCT 40930008) Morbid obesity (SCT 238136002)
Allergies: none
Diagnostic Lab Data: Report Exam: CT HEAD W/O CONT, CT MAXILLOFACIAL W/O CONT Scanned in room 9 pt wore mask CT Head and MF w/o per Dr History: increased pain behind both eyes x 5 days/sinus pressure/ medial squint right eye x 4 days. double vision x 4 days Findings: Computed tomographic images of the maxillofacial region as well as the head were obtained in the axial projection with additional sagittal and coronal reformatting. Dose:Up-to-date CT equipment and radiation dose reduction techniques were employed. CTDIvol: 45.9 mGy. DLP: 1262 mGy-cm. Multiple computed tomographic images of the head were obtained without contrast enhancement. There are no mass lesions or bleeds. No subdural or epidural collections of blood or fluid are present. There is no shift of midline structures. The ventricles are not pathologically enlarged. The bony calvarium is intact throughout. The temporal bones and internal auditory canals are unremarkable bilaterally. The pituitary gland and pituitary fossa are unremarkable. Images through the maxillofacial region demonstrate no significant bony abnormalities. Metallic dental work causes extensive streak artifact across the mandibular region and lower maxilla obscuring detail. The paranasal sinuses are well pneumatized and normal bilaterally. The orbits and periorbital regions are unremarkable. The temporomandibular joints are symmetrical and normal bilaterally. The nasopharyngeal airways, tonsillar regions, tongue, and upper pharyngeal regions are unremarkable.
CDC Split Type:

Write-up: MVX (Manuf); Lot#; Exp Date: JSN; 042A21A; 06/21/2021 vaccine info Cranial nerve 6 palsy 2 months after vaccine -Sinus pain refractory to his usual ibuprofen/antihistamine began Saturday and new onset diplopia started Monday -VA 20/20- and 20/20 -IOP 16, 15 -Restriction in right upper, right lateral and right lower gaze of the right eye. Full EOM OS -Binocular horizontal diplopia that goes away with covering 1 eye -Denies recent illness, GCA symptoms -PMHX hypothyroidism and obesity. No DM or HTN (BP today 142/80 - pt reports his BP is usually lower) -Anterior exam wnl -DFE without optic disc swelling or obscuration of vessels -Pt has no other FND. CN II-XII intact except for CN VI -Humphrey visual field: full with no defects


VAERS ID: 1587075 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-11
Onset:2021-08-11
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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:
Allergies:
Diagnostic Lab Data: Positive SARS-CoV-2 by PCR from specimen collected 8/18/21
CDC Split Type:

Write-up: Known exposure to +COVID household contact, presented to ED with cough, fever, chills, loss of taste/smell, generalized body aches.


VAERS ID: 1587093 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Diarrhoea, Electrocardiogram abnormal, Headache, Myalgia, Pyrexia, Sleep disorder, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness:
Preexisting Conditions: Permanent thyroid issues do to total thyroidectomy after thyroid cancer.
Allergies:
Diagnostic Lab Data: Full blood panel completed ? my only abnormality was low WBC which my doctor says is normal after being vaccinated. EKG completed ? I had some arrhythmia after receiving the vaccine that has now let up. The EKG showed proof of a slowed heart beat. Doctor said diarrhea was nothing to worry about?
CDC Split Type:

Write-up: After the initial fever, muscle aches, and headache subsided about 48 hours after receiving the one-shot vaccine, the chronic diarrhea remained. I have never suffered from diarrhea, only constipation in the past. Now I have diarrhea several times a day, it even wakes me up at night. My diet is clean (fruits, veggies, grains, vegan proteins) and I don?t drink coffee or alcohol. This started the day after receiving my shot and has not let up since (I am 17 days post vaccine now).


VAERS ID: 1587164 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Asthenia, Blepharospasm, Chest discomfort, Chest pain, Dizziness, Dyspnoea, Eye movement disorder, Gait inability, Headache, Hypoaesthesia, Musculoskeletal stiffness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Arthritis (broad), Sexual dysfunction (broad)

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

Write-up: Heavy chest, stabbing pain on left side of chest, numbness on the right side of face, dizziness, severe headaches, stiff muscles, very weak feeling, shortness of breath, unable to talk and walk for 2 weeks, rapid eye movement, eye twitching.


VAERS ID: 1587237 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-06
Onset:2021-08-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site swelling, Rash
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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, pamolor ptometrium, singular, metformin,
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: omnicef pcn, hydrocodone
Diagnostic Lab Data: none
CDC Split Type:

Write-up: over 24 hour injection site swelling occurred with spread of rash across chest toward back and toward forearm. treated 4 days later in ED with benadryl and steroids with immediate improvement.


VAERS ID: 1587265 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-07-17
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: School       Purchased by: ?
Symptoms: Angiogram, Angiogram normal, Caesarean section, Chorioretinopathy, Computerised tomogram head normal, Exposure during pregnancy, Magnetic resonance imaging spinal normal, Magnetic resonance imaging thoracic normal, Plasmapheresis, Platelet count decreased, Platelet transfusion, Premature delivery, Premature separation of placenta, Third trimester pregnancy, Thrombotic thrombocytopenic purpura
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, arterial (narrow), Retinal disorders (narrow), Renovascular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: none.
Preexisting Conditions: none.
Allergies: none.
Diagnostic Lab Data: Platelets down to nadir of 9,000. MRI of lumbar spine - negative. MRI of thoracic spine - negative. CT brain and CT angiogram - negative.
CDC Split Type:

Write-up: thrombotic thrombocytopenic purpura leading to a placental abruption, emergency c-section at 35 weeks of pregnancy. birth weight was 4lb 4.1oz. Pt received several units of platelets, several days of plasmapheresis. Diagnosed with central serous retinopathy.


VAERS ID: 1587390 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Lip pruritus, Paraesthesia oral, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: FLU VACCINE TS 2015-16 (5 YR+) 10/26/2015 Got facial swelling after getting flu shot.
Other Medications: predniSONE (DELTASONE) 10 mg Oral Tab Famotidine (PEPCID) 20 mg Oral Tab EPINEPHrine (ADRENACLICK/EPIPEN) 0.3 mg/0.3 mL Inj AutoInjector Cetirizine (ZyrTEC) 10 mg Oral Tab
Current Illness: N/A
Preexisting Conditions: HTN (HYPERTENSION) HX OF LASIK FEMALE STRESS INCONTINENCE MASTALGIA. FHX OF BREAST CANCER CHRONIC PAIN COUNSELING HX OF THYROIDECTOMY HX OF LASER REFRACTIVE SURGERY BENIGN CARCINOID TUMOR, LUNG ELEVATED H PYLORI ANTIBODY BILAT DRY EYE SYNDROME BILAT AGE RELATED CATARACT
Allergies: Avocado - DietaryAnaphylaxis Dilaudid [Hydromorphone]Hives CodeineRash Covid-19 Vaccine, Ad26.cov2.s (Janssen) Flu Vaccine Ts 2015-16 (5 Yr+) Latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 1649 Pt received dose of Janssen (Johnson & Johnson) vaccine today approximately around 1440. Pt states she is "feels like I''m going to throw up". Pt brought back to AR triage for observation. Pt states feeling lightheaded and feels tingling and itching around lips. Vital signs at 1652: BP: 160/103 (Map: 133) HR: 73 SPO2: 99% Temp: 98.2 F RR: 21 1658: Spoke with emergency department Dr. about patients situation. Dr. advises that 911 be called and patient be taken to emergency department, due to high blood pressure and itching around face. 1702: 911 called. Pt still feeling itching around lips and face. Vital Signs at 1702: BP: 212/106 (Map: 139) HR: 67 SPO2: 93% Temp: 97.4 F RR: 22 1720: Pt states itching around lips, face, and now throat. Pt also states "It''s hard to swallow and my tongue feels big". Paramedics arrived and administered IM epinephrine. Pt was taken to ER by paramedics


VAERS ID: 1587404 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bronchitis, Cough, Decreased appetite, Diarrhoea, Fatigue, Haematochezia, Headache, Lymphadenopathy, Oral discomfort, Pain, Pharyngeal swelling, Pharyngitis, Productive cough, Pyrexia, Vomiting, Weight increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 12.5 mg daily Hydrochlorot were the only meds taken that day
Current Illness: none
Preexisting Conditions: RA
Allergies: No known drug allergies
Diagnostic Lab Data: 2 urgent care visits following the vaccine 7/16/2021 and 7/19/2021 Urgent Care
CDC Split Type:

Write-up: day 1 and 2 after the vaccine I had a fever 100.2, vomiting, headache, loss of appetite, extreme fatigue, diarrhea, and body aches day 3, 4, and 5 blood in my stool day 5, swollen throat, and glands and burning ring around my lips, went to urgent care was advised to take a benadryl day 7 heavy bronchitis symptoms went to urgent care diagnosed with bronchitis. This lasted for two week Still experiencing residuals from bronchitis with cough, phlegm, and pharyngitis In the first two weeks I gained 7 lbs


VAERS ID: 1587438 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-17
Onset:2021-04-19
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: lymphadenopathy of left axilla started one month after injection, persisting for 4 months and ongoing


VAERS ID: 1588526 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: Patient medical emergency - post COVID 19 J&J vaccine Episode started at 1126 - patient was in observation room with Mother at Side Patient became diaphoretic, clammy, pale white, then had a syncope episode. .3mg Epi given by this RN in left quad. 1129: BP 77/33 P 92 Patient reported chest tightening Patient was brought to the ground legst propped up on chair. O2 applied at 8L via Nasal Cannula Stat: 97% RN instructed to call 911 911 dispatched 1134: P 47 O2 99% 1135: BP 141/58 P 58 1140: Patient transferred


VAERS ID: 1589066 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Headache, Hypersensitivity, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metroNIDAZOLE (METROCREAM) 0.75 % topical cream blood glucose test strips (ONETOUCH VERIO) albuterol (PROVENTIL HFA) 90 mcg/actuation inhaler clonazePAM (KLONOPIN) 1 mg tablet ALPRAZolam (XANAX) 0.5 mg tablet clonazePAM (KLONOPIN) 1 mg tabl
Current Illness: Hyperparathyroidism
Preexisting Conditions: DM2, hyperlipidemia
Allergies: Severity Reactions Comment Codeine High Nausea, Vomit Morphine High Unknown Morphine Sulfate High Itching Silver Medium Itching Paroxetine Not Specified Nausea Sertraline Not Specified Unknown Trazodone Not Specified Other Headache Latex Low Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 58 year old female who began having shortness of breath, nausea, extreme headache and coughing 10 min after receiving her JJ COVID-19 vaccination. She was brought in to the Urgent Care, noted to be having an allergic reaction and was immediately given 50 mg of Benadryl, 8 mg of ondansetron and observed for 5 min. She continued having worsening symptoms with coughing and shortness of breath, 125 mg of Solu-Medrol were given IM and she was placed on 12 L O2 non-rebreather mask. The patient reported feeling progressive throat tightening and chest tightness and her coughing fits increased. Epinephrine 0.3 mg was administered to the left lateral thigh and the EMS system was activated. After the epinephrine her symptoms improved, however did not fully resolved. EMS arrived Within 10 min and received report transporting the patient to ER for further evaluation.


VAERS ID: 1589092 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-21
Onset:2021-07-28
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Gait disturbance, Hypoaesthesia, Pain in extremity, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: knee replacement. Bariatric gastric bypass. kidney stones.
Allergies:
Diagnostic Lab Data: neurology test and blood test scheduled ASAP
CDC Split Type:

Write-up: Numbness in lower right leg and foot. Numbness in left toes. occasional fingers tinkling and pain. Can''t walk normal. fels like my foot fell asleep and I''ve twisted ankle because I didn''t feel the step. Major pain after wearing work boots more than a few hours. occasional throwing up. Fatiguing. Dizziness and faint feeling


VAERS ID: 1591167 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-01
Onset:2021-05-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Biopsy skin, Dermatitis
SMQs:, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Cozaar, Flomax, Norvasc, Synthroid, Zocor
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: 8/18 punch biopsy (results pending)
CDC Split Type:

Write-up: prolonged dermatitis on predominately sun exposed skin


VAERS ID: 1591281 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine-hypotension and fever
Other Medications: unknown
Current Illness: no
Preexisting Conditions: depression
Allergies: flu vaccine, iodinated contrast, codeine
Diagnostic Lab Data: pending
CDC Split Type:

Write-up: 0930: Patient reporting "tingling" in tongue after J&J COVID vaccine. 0933 Patient reports difficulty swallowing. Epi 0.3mg given IM R thigh. 0937 Patient reporting continued tingling, feels as though tongue is "thick". Reports swallowing has improved. Itching on bottom lip. 0946 Patient taken to ED by ED RNs via stretcher.


VAERS ID: 1591510 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-06
Onset:2021-08-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood creatine phosphokinase, Blood test, C-reactive protein, Chest pain, Computerised tomogram, Electrocardiogram abnormal, Fatigue, Headache, Hypoaesthesia, Magnetic resonance imaging, Muscular weakness, Pain, Pain in extremity, Pericarditis, Pyrexia, Red blood cell sedimentation rate, Scan with contrast
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fiber supplement
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa antibiotics
Diagnostic Lab Data: 8/18 CT Scan with contrast, MRI, EKG, Blood work, and physical examination ruled out stroke. 8/20 Follow-up visit with GP performed C-Reactive Protein, CK Total, and Erythrocyte Sedimentation Rate blood work. Results pending. Additional EKG performed. EKG showed abnormality consistent with Pericarditis. Began treatment as prescribed.
CDC Split Type:

Write-up: Initial pain and fever on 8/7/2021. Pain in left arm turned into numbness. Numbness extended down the arm and severe headaches persisted. Weakness in muscles including legs developed after about 5-6 days. Overall, extreme exhaustion and weakness after the first week. Chest pain developed. On 8/18, numbness on the left side of my face appeared. All other symptoms previously noted were present.


VAERS ID: 1591586 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-03
Onset:2021-08-16
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec, zofran, prinivil,
Current Illness:
Preexisting Conditions: Pancreatitis, cholangitis, high BP, thromocytopenia, elevated LFTs, hypocalcemia, vit. D deficiency, elevated PSA,
Allergies:
Diagnostic Lab Data: Swabbed positive for covid on admission 8/16/2021
CDC Split Type:

Write-up: Came in for cholangitis


VAERS ID: 1591678 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-23
Onset:2021-07-30
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Decreased appetite, Diarrhoea, Feeling abnormal, Nausea, Occupational exposure to SARS-CoV-2, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness:
Preexisting Conditions: prostate cancer on chemotherapy
Allergies: NKDA
Diagnostic Lab Data: SARS CoV 2 PCR COVID-19 Positive on 7/30/2021 according to patient Repeat SARS CoV 2 PCR COVID-19 Positive on 8/8/2021 upon admission
CDC Split Type:

Write-up: 8/8/21: Patient states he decided to go get tested for COVID19 due to being exposed to a co-worker that was feeling poorly. He reports he had a positive COVID test on 07/30/2021 and states he was not really having symptoms at that time but eventually started having persistent diarrhea, occasional nausea and decreased appetite as well as having a nonproductive cough, that was exacerbated with deep breathing. He reports he came to the ED due to not feeling any better. Repeat COVID testing on 8/8/21 in ED was positive again and patient was admitted for further eval. He reports being fully vaccinated with Johnson & Johnson vaccine in May 2021. 8/9/21: Patient discharged home He states he has been using over-the-counter Robitussin at home but has not been on any other prescription medications. In the ED, patient had O2 saturations 91% on room air and was placed on 2 L nasal cannula. Repeat COVID testing positive again. He received a normal saline bolus, Decadron, and Zofran in the ED and reports feeling better.


VAERS ID: 1591802 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood test, Chest pain, Computerised tomogram thorax normal, Dyspnoea, Fatigue, Fibrin D dimer increased, Headache, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: I received the vaccine at 3:30 pm, at my job. I went home and later that event around 8:30 pm, I became severely fatigued, weak, tingling in both my legs and a severe headache. Those symptoms have lasted since receiving the vaccination. I developed chest pain and shortness of breath on the 18th of August. I was seen in the emergency room on the 19th and had blood work done. D-dimer test came back elevated and a Ct scan was done on my chest only. No pulmonary clots were been found. Symptoms are still present. I take Tylenol for the headache which offers temporary relief.


VAERS ID: 1591816 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-18
Onset:2021-06-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Haemorrhage, Infection, Mass excision, Neoplasm malignant, Paranasal sinus mass, Sinonasal obstruction
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Non-haematological malignant tumours (narrow)

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

Write-up: Within a week or two weeks after getting my vaccine, on my left sinus I grew a mass that was about half an inch in diameter. That caused complete blockage in my sinus track. I was unable to breathe and had an infection show up. The mass was removed July 26th by a Dr. On August 6, we found out it was classified as a small blue cell malignant tumor. I am going to MD at the end of the month on August 31st to undergo further tests and treatment. This tumor is extremely rare. I am the 4th person that they have found this tumor on. The mass was sent to a diagnostics lab. One of the tumors came out on it''s own and I nearly bled out so I went to the ER. They were able to get the bleeding to stop.


VAERS ID: 1591826 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-15
Onset:2021-06-30
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Laboratory test, Pyrexia, X-ray normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: X-rays negative, labs pending.
CDC Split Type:

Write-up: Joint pain and sensation of febrile. I was an avid runner prior and now cannot due to bilateral ankle pain for past 3 months. I am currently undergoing physical therapy and work up for possible autoimmune condition.


VAERS ID: 1591912 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, Nervousness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: A little after 4pm on 8/18/21 patient got his J&J covid vaccine. He was nervous about the vaccine and did not like needles. After the vaccine he seemed calm and chatted with me for a minute before going and having a seat in the waiting area. A few minutes after he sat down the patient fainted - falling towards another patient who was waiting after his vaccine. The other patient said it looked like he was having a seizure. Staff member called 911 right away. I ran out and saw the patient still falling from his chair. He bumped his head as he fainted and me and the other patient helped him to the ground. He came to within seconds and kept apologizing. I told him not to apologize and got him some water. He kept saying he was fine. EMS arrived and took some vitals. They said the patient could go to the hospital if he wanted and he said he didn''t want to go. They were getting his paperwork together when he fainted a second time. They took him by ambulance to Medical Center.


VAERS ID: 1591915 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site bruising, Limb discomfort, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: 41 yo female received J&J Covid vaccine on 11AUG2021 at Health Department. Pt states left arm began to feel numb, tingling, within 30 minutes of vaccine. The numbness and tingling described by the patient spread to pt''s face, head, neck and right wrist. Pt was evaluated at local urgent care and advised of possible histamine reaction with recommendation for ibuprofen and prednisone. Symptoms have worsened over 8 days reporting heaviness in left arm with continued left arm tingling and numbness. Mild bruising noted at injection site, pt denies pain, redness or rash. No previous immunization reaction reported by pt.


VAERS ID: 1591939 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-13
Onset:2021-08-09
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1085025 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Lung opacity, Nodule, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Chest CT 3/20/21 Incidental single ground glass nodule $g 6 mm; 2/21/2021 probably benign, partially effacing right breast asymmetry and a left breast mass versus complicated cyst
Preexisting Conditions: NIDDM, obesity
Allergies: NKDA
Diagnostic Lab Data: 8/9/2021: SARS CoV 2 PCR COVID-19 Positive
CDC Split Type:

Write-up: 8/9/21: Pt presents to the ED with the CC of SOB x 2 days. Patient admits to SOB, loss of appetite, fever, diarrhea, loss of sense of taste and smell, cough but denies chills, nausea, vomiting, chest pain, abdominal pain, headache, or any other symptoms at this time. Patient verbalized receiving Johnson & Johnson COVID-19 vaccination-admin March 2021. Patient also verbalized been noncompliant with diabetic medications because it makes her tremble. 8/9/21: Pt tests positive for COVID upon admission 8/15/21: Pt discharged


VAERS ID: 1591947 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-03-21
Onset:2021-08-17
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Paranasal sinus discomfort, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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:
Allergies: Penicillin
Diagnostic Lab Data: Tested positive for COVID on 8/20/2021
CDC Split Type:

Write-up: Tested positive for COVID on 8/20/2021. Symptoms: Headache, congestion, sinus pressure, cough.


VAERS ID: 1591953 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-07
Onset:2021-08-04
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805032 / 1 - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cerebral ventricle dilatation, Computerised tomogram head abnormal, Normal pressure hydrocephalus, SARS-CoV-2 test positive
SMQs:, 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? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Type 2 diabetes, HLD, ichthyosis, HTN, cognitive impairment-possible TIA
Allergies: No known drug allergies
Diagnostic Lab Data: 8/4/2021: SARS CoV 2 PCR COVID-19 Positive
CDC Split Type:

Write-up: 8/3/2021 Pt presents to ER. CT brain that shows no hemorrhage or CT evidence for acute large vessel infarction, marked ventriculomegaly out of proportion to the degree of sulcal atrophy. Findings are concerning for normal pressure hydrocephalus. He was seen by the stroke neurologist, who recommends activated stroke protocol admission order set, stroke/telemetry floor, neuro checks, bedside swallow eval, DVT prophylaxis, IV fluids, normal saline, head of the bed 30 degrees, euglycemia, avoid hyperthermia. Cleared for dc 8/2 however prior to SNF placement, tested positive for COVID-19. Of note, patient received J&J COVID-19 vaccine March 2021. 8/11/2021: Pt discharged to SAR


VAERS ID: 1591956 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-19
Onset:2021-07-24
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, COVID-19, Dyspnoea, Dysuria, Hypoxia, Nausea, Refusal of treatment by patient, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Respiratory failure (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? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: DM, HTN, HLD, diabetic
Allergies: lisinopril
Diagnostic Lab Data: 7/24/2021: SARS CoV 2 PCR COVID-19 Positive
CDC Split Type:

Write-up: 7/24/2021: Pt presents to ED complaining of migrating joint pain and back pain for the past 3 days. She notes that she did vomit 1 time earlier today, but is no longer nauseous. She has been compliant with her diabetes medications. Patient noticed some dysuria earlier today.. The onset was 3 days ago. Patient dc home same day. 7/25/2021: Pt presents to ED with similar symptoms as day prior. Patient tests positive for COVID-19 upon admission. Patient discharged home on 8/1 8/1/2021: Pt presents to ED with CC SOB. Per patient, recently tested positive for COVID-19 (7/24/2021) and reports having worsening SOB and hypoxia that was recorded at 66% O2 at room air with her home monitoring kit. Pt arrives to the ED in


VAERS ID: 1591967 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-07-28
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202AZ1A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Condition aggravated, Cough, Fatigue, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Somnolence
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: CHF with combined systolic and diastolic dysfunction, Atrial Fibrillation, HLD, CVA with left sided residual weakness, renal insufficiency, DM, hx of seizure
Allergies: NKDA
Diagnostic Lab Data: 7/29/2021: SARS CoV 2 PCR COVID-19 Positive
CDC Split Type:

Write-up: 7/29/2021: presented to HCF via EMS for Fever. Per patients'' son she has been febrile over the last 24 hours as high as 102.5. She did receive the Johnson & Johnson Vaccine about 1 month ago. On arrival to ED pt''s temperature is 103.4, blood pressure 219/88. Chest x ray showed cardiomegaly with CHF. Pt tests positive for COVID 7/29/21. Transferred to another HCF for care same day. 7/31/2021: Pt dc to home, then 8/11/2021: Per patient, since getting home from her recent discharge on 07/31/21 pt has been having persistent cough and congestion. Pt was treated for COVID-19. Her PCP has prescribed her medication to avoid visiting the ED, however pt has had worsening fatigue as she reportedly sleeps all day and has been nonproductive. 8/16/2021: Patient still hospitalized at the time of this report submission.


VAERS ID: 1591997 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

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

Write-up: Loss of consciousness for under 30 seconds EMS was called and patient was awake and alert upon their arrival. Patient was light headed and dizzy so EMS encouraged patient to be further evaluated at the ER.


VAERS ID: 1592014 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Gingival erythema, Gingival swelling, Head injury, Headache, Sinusitis, Skin laceration, Suture insertion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Gingival disorders (narrow), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Fainting : transfer to emergency room for gash on forehead after hitting head on floor; glue suture about 1 inch Headaches, fatigue, faint: 4- 6 days following vaccine Swollen/red gums: 6 days after vaccine; treated with antibiotics Sinus Infection: 6 days after vaccine; treated with antibiotics


VAERS ID: 1592119 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-30
Onset:2021-07-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Muscle spasms
SMQs:, Anaphylactic reaction (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flexeril, Ibuprofen, Minocycline
Current Illness:
Preexisting Conditions: GERD, Depression, Thoracic Radiculopathy
Allergies: Oxycodone, Wellbutrin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Report of 3 weeks of muscle cramping, intermittent chest tightness


VAERS ID: 1592562 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

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

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

Write-up: Patient received 1dose of the JJ vaccine approximately 3 minutes later patient complained of being dizzy......patient lost consciousness for about 20 seconds came to then began to sweat. Ambulance was called and arrived within 4 minutes. Patient was evaluated then transported to local hospital to be checked out.


VAERS ID: 1592570 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-27
Onset:2021-08-15
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pepcid, Allegra, flo nase
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: Pending / still hospitalized
CDC Split Type:

Write-up: Blood clots, pulmonary embolisms (4), hospitalized 5 days so far with likely a few more days to go barring any more set backs


VAERS ID: 1592588 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Blood glucose normal, Disorientation, Headache, Hyperhidrosis, Hypoaesthesia, Nausea, Pallor, Presyncope, Sitting disability, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt. unable to give full list of medications: Metformin 1,000mg BID, Carvedolol ? dose. States he is on eight medications. Denies taking any blood thinners.
Current Illness: History of Hypertension, ADD, Episodes of Syncope " 3 events in last two years". Also states has not had medical care in last 20 years until recently when placed on current meds. Does not check blood glucoses.
Preexisting Conditions: As above stated.
Allergies: NKDA
Diagnostic Lab Data: FSBS=105
CDC Split Type:

Write-up: 1:10 Received vaccine. Pt. alert, oriented,having no health issues. 1:20 Became weak, diaphoretic, nauseated, near syncope. Placed supine with cold compress to head. B/P 140.80 P- 80 R-20 Sat 97%. FSB:105. Pt. admits has only eaten fruit today and no oral fluids. Water taken in sips. Peanut butter crackers given. Pt. reports his vision is blurred and he has a severe headache. 1 :30 Vital signs unchanged. Pt''s color very pale. Denies any improvement. Now noticing numbness of face, chest, neck, and abdoman. Disoriented to time, place, and person. Unable to give any information for contacting family. Unable to sit up under own power. EMS notified. No change in Vital signs. 1:55 EMS evaluated and transferred to Medical Center. Condition unchanged.


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