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From the 10/8/2021 release of VAERS data:

Found 7,946 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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VAERS ID: 1594350 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-04
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Computerised tomogram, Laboratory test, Malaise, Pulmonary thrombosis
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210805; Test Name: CT scan; Result Unstructured Data: blood clots on lungs; Test Name: Lab test; Result Unstructured Data: negative for any sort of hereditary disease
CDC Split Type: USJNJFOC20210832359

Write-up: BLOOD CLOTS ON LUNGS; PAIN IN BACK; PAIN IN SHOULDERS; WASN''T FEELING WELL; This spontaneous report received from a parent concerned a 27 year old, male. The patient''s weight was 200 pounds, and height was 70.5 inches. The patient''s pre-existing medical conditions included: The patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 21-SEP-2021) dose was not reported, one total administered on right arm on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-AUG-2021, the patient wasn''t feeling well and had pain in shoulders and pain in back. On 05-AUG-2021, the patient experienced chest pain that got worse with deep breath, and went to urgent care and was later on that day, the patient was sent to emergency room and ran a bunch of tests including a CT scan and found blood clots on his lungs. The patient was hospitalized on the same day and was kept on Heparin until 08-AUG-2021 On an unspecified date, laboratory test of hereditary disease was performed whose results were negative. On 08-AUG-2021, the patient was discharged with a prescription for a blood thinner, Eliquis, for an unknown amount of time. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of wasn''t feeling well, pain in shoulders, pain in back and blood clots on lungs was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210832359-covid-19 vaccine ad26.cov2.s-blood clots on lungs; pain in back. This case concerned to a concerned a 27 year old, male patient. 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). 20210832359-covid-19 vaccine ad26.cov2.s-pain in shoulders; wasn''t feeling well. This event(s) is labeled and is therefore considered potentially related.


VAERS ID: 1594371 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia, Pharyngeal swelling, Pulmonary thrombosis, Rhinorrhoea, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Embolic and thrombotic events, venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydroxyzine HCL; Losartan; Amlodipine; Tradjenta; Tylenol
Current Illness: Abstains from alcohol; Non-smoker.
Preexisting Conditions: Comments: The patient did not have known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210832975

Write-up: BLOOD CLOTS IN LUNGS; SHOULDER AND LEFT BREAST LEFT SIDE FEELS PARALYZED/ ARMS AND LEGS FEEL PARALYZED; HANDS, ARMS GOT TINGLING SENSATION; SWOLLEN THROAT; INFECTIOUS STUFF THAT WAS COMING OUT OF HER MOUTH AND NOSE; This spontaneous report received from a patient concerned a 67 year old female of mixed race half white and half Indian and unknown ethnic origin. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: non alcoholic, and non smoker, and the patient did not have known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, expiry: UNKNOWN) frequency one total, dose was not reported on right arm, administered on 05-APR-2021 for prophylactic vaccination. Concomitant medications included amlodipine besilate (10mg), hydroxyzine hydrochloride (25mg), Tradjenta (5mg), losartan (100mg), and paracetamol (Tylenol). After three days of vaccination the patient could not breath, went to the hospital (emergency room) on 08-APRIL-2021. A radio dye was injected and the patient was diagnosed with blood clots in her lungs. The patient was coughing blood and had a swollen throat. The patient was treated with Antibiotics and Nasal Spray for infectious stuff that was coming out of her mouth and nose. She was released from the hospital on 08-Apr-2021. She was on Oxygen and cannot breath. The patient experienced shoulder and left breast -left side feels paralyzed / arms and legs feel paralyzed, hands, arms got tingling sensation. Treatment medications (dates unspecified) included: Xarelto (20mg) (rivaroxaban) The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from blood clots in lungs, coughing blood, can''t breath, shoulder and left breast -left side feels paralyzed / arms and legs feel paralyzed, swollen throat, and hands, arms got tingling sensation, and the outcome of infectious stuff that was coming out of her mouth and nose was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition). This case, from the same reporter is linked to 20210832472.; Sender''s Comments: V0: 20210832975- covid-19 vaccine ad26.cov2.s-blood clots in lungs. 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: 1594410 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (Occasionally); Allergic reaction to bee sting; Latex allergy; Non-smoker; Shellfish allergy
Preexisting Conditions: Comments: Patient did not had any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210835319

Write-up: HIVES WITH ITCHING; This spontaneous report received from a patient concerned a 73 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: latex allergy, bees allergy, shellfish allergy, non smoker, and alcoholic, and other pre-existing medical conditions included: Patient did not had any drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the patient experienced hives with itching. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from hives with itching. This report was non-serious.


VAERS ID: 1594418 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-26
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? 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: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: Patient have no known allergies, no medical history and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210426; Test Name: CT scan; Result Unstructured Data: Indicated stroke
CDC Split Type: USJNJFOC20210835603

Write-up: STROKE; This spontaneous report received from a consumer (husband of patient) concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non alcohol user and non smoker and other pre-existing medical conditions included no known allergies, no medical history and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, 1 total, administered in last week of MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 26-APR-2021 at 7.00 am, daughter of patient found that the patient was on the floor and staring at ceiling. The patient was taken to the Emergency Room (ER). The physician of emergency room said that patient had a stroke. On the same day patient was transferred to the hospital where computed tomography (CT Scan) was done and a stroke was confirmed (patient would see the back physician in OCT-2021) did not have any specific information or the test results. The patient was completely healthy with no medical condition. The patient was under the care of physician. The date of admission and discharge from hospital were not reported. Number of days of hospitalization was not reported. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of stroke was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210835603- covid-19 vaccine ad26.cov2.s-Stroke. 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: 1594419 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-08-15
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Allergy to vaccine, Blood pressure fluctuation, Blood test, Blood thyroid stimulating hormone, Chest discomfort, Dizziness, Dysgeusia, Electrocardiogram, Fatigue, Feeling abnormal, Feeling cold, Full blood count, Headache, Heart rate, Hot flush, Hyperhidrosis, Malaise, Metabolic function test, Muscular weakness, Palpitations, Paraesthesia, Sensory loss, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HYDROXYCHLOROQUINE
Current Illness: Dermatomyositis (She takes 200 mg hydroxychloroquine once per day.)
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to chemicals (She stated that she was told this may be a problem for her prior to receiving the vaccine and proceeded anyway as she requires vaccination before her eye surgery.); Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: Heart rate; Result Unstructured Data: 104 to 124 beats per minute; Test Date: 20210815; Test Name: Heart rate; Result Unstructured Data: 124 {beats}/min; Test Date: 20210815; Test Name: Heart rate; Result Unstructured Data: 80 {beats}/min; Test Date: 20210815; Test Name: Heart rate; Result Unstructured Data: Elevated; Test Date: 20210816; Test Name: TSH; Result Unstructured Data: Normal; Test Date: 20210816; Test Name: Troponin; Result Unstructured Data: Normal; Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: 117 to 120 beats per minute; Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: 120 {beats}/min; Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: over 100 beats per minute; Comments: On 16 Aug at 06:30 am; Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: Returned to 78 beats per minute; Comments: Around 07:30 am; Test Date: 20210816; Test Name: Comprehensive metabolic panel; Result Unstructured Data: Normal; Test Date: 20210816; Test Name: Blood test; Result Unstructured Data: Normal; Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: did not go over 100 and fluctuated to 88, sometimes to 90 beats per mi; Comments: did not go over 100 and fluctuated to 88, sometimes to 90 beats per minute; Test Date: 20210816; Test Name: ECG; Result Unstructured Data: Normal; Test Date: 20210816; Test Name: CBC; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210835627

Write-up: METAL TASTE IN MOUTH; NOT EXPERIENCING THE SENSATION; FELT COLD; TINGLING IN LEFT HAND; HEADACHE/HEAD THROB/HEAD POUNDING (4 OUT OFF 10 PAIN LEVEL AND INCREASED TO 7 OUT OFF 10 AFTER ONE DAY 6 OUT OFF 10 INITIALLY THEN 5 OUT OFF 10); EXHAUSTED; SWEATING PROFUSELY/SWEATY PALMS/FELT CLAMMY; HORSE KICKED IN THE CHEST; FEELING SOMETHING MOVING THROUGH THAT GETTING SO OVERHEATED/FELT TERRIBLE AND KEPT DOZING IN AND OUT OF SLEEP/EXHAUSTED AND JUST WIPED OUT AND FELT LIKE RAN A MARATHON/FELT TERRIBLE; CANNOT MOVE ARMS; POUNDING IN CHEST/HEART BEATING HARD; HEART RATE FLUCTUATION; BLOOD WAS BOILING (FROM THE TIP OF TOES MOVING TOWARDS TO HEAD)/HOT FLASHES AT THE TOP OF THE HEAD DOWN TO TOES/BROKE OUT IN A HOT SWEAT; ALLERGIC REACTION TO VACCINE; LIGHT HEADED; NOT FEELING GOOD; This spontaneous report received from a patient concerned a 65 year old female. The patient''s weight was 140 pounds, and height was 175 centimeters. The patient''s concurrent conditions included: dermatomyositis, and peg allergy. The patient experienced drug allergy when treated with macrogol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: UNKNOWN) dose was not reported, administered on 15-AUG-2021 for prophylactic vaccination. Concomitant medications included hydroxychloroquine for dermatomyositis. On 15-AUG-2021, the patient experienced pounding in chest/heart beating hard. On 15-AUG-2021, the patient experienced heart rate fluctuation. On 15-AUG-2021, the patient experienced blood was boiling (from the tip of toes moving towards to head) /hot flashes at the top of the head down to toes/broke out in a hot sweat. On 15-AUG-2021, the patient experienced allergic reaction to vaccine. On 15-AUG-2021, the patient experienced light headed. On 15-AUG-2021, the patient experienced feeling something moving through that getting so overheated/felt terrible and kept dozing in and out of sleep/exhausted and just wiped out and felt like ran a marathon/felt terrible. On 15-AUG-2021, the patient experienced cannot move arms. On 15-AUG-2021, the patient experienced not feeling good. Laboratory data included: Heart rate (NR: not provided) Elevated, 80 {beats}/min, 124 {beats}/min, 104 to 124 beats per minute. On 16-AUG-2021, the patient experienced sweating profusely/sweaty palms/felt clammy. On 16-AUG-2021, the patient experienced horse kicked in the chest. On 16-AUG-2021, the patient experienced headache/head throb/head pounding (4 out off 10 pain level and increased to 7 out off 10 after one day 6 out off 10 initially then 5 out off 10). On 16-AUG-2021, the patient experienced exhausted. Laboratory data included: Blood test (NR: not provided) Normal, CBC (NR: not provided) Normal, Comprehensive metabolic panel (NR: not provided) Normal, ECG (NR: not provided) Normal, Heart rate (NR: not provided) 120 {beats}/min, 117 to 120 beats per minute, Returned to 78 beats per minute, over 100 beats per minute, did not go over 100 and fluctuated to 88, sometimes to 90 beats per mi, TSH (NR: not provided) Normal, and Troponin (NR: not provided) Normal. On 17-AUG-2021, the patient experienced metal taste in mouth. On 17-AUG-2021, the patient experienced not experiencing the sensation. On 17-AUG-2021, the patient experienced felt cold. On 17-AUG-2021, the patient experienced tingling in left hand. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache/head throb/head pounding (4 out off 10 pain level and increased to 7 out off 10 after one day 6 out off 10 initially then 5 out off 10) on 17-AUG-2021, had not recovered from pounding in chest/heart beating hard, heart rate fluctuation, and blood was boiling (from the tip of toes moving towards to head)/hot flashes at the top of the head down to toes/broke out in a hot sweat, and the outcome of light headed, not feeling good, cannot move arms, sweating profusely/sweaty palms/felt clammy, exhausted, tingling in left hand, metal taste in mouth, horse kicked in the chest, felt cold, allergic reaction to vaccine, feeling something moving through that getting so overheated/felt terrible and kept dozing in and out of sleep/exhausted and just wiped out and felt like ran a marathon/felt terrible and not experiencing the sensation was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1594421 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Acute kidney injury, Deep vein thrombosis, Fall, Loss of consciousness, Pulmonary embolism, Rhabdomyolysis
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug abuse; Embolectomy; Gynecomastia; Oral gonorrhea; Panic attacks; Prehypertension; Syphilis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210835633

Write-up: LOST CONSCIOUSNESS; RHABDOMYOLISIS; TRAUMATIC FALL; PULMONARY EMBOLISM; ACUTE KIDNEY INJURY; DEEP VEIN THROMBOSIS IN RIGHT LOWER LEG; This spontaneous report received from a physician concerned a 38-year-old Male, race and ethnicity unknown. The patient''s weight was 96 kilograms, and height was 183 centimeters. The patient''s past medical history included panic attacks, prehypertension, syphilis, oropharyngeal gonorrhea, mild gynecomastia, and amphetamine use disorder. The patient was not on any medication at the time of event. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, frequency 1 total, administered on 10-Apr-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-Jul-2021, the patient lost consciousness at home and was transported by ambulance to the local emergency Room. The patient was hospitalized on an unspecified date. The patient was found to have deep vein thrombosis in right lower leg and extensive pulmonary emboli. The reporter stated that no predisposing factors developed DVT (deep vein thrombosis) such as long time in stationary position or trauma to leg. The Patient was taken to the operating room for embolectomy and was started on anticoagulants. The patient experienced rhabdomyolysis due to traumatic fall and acute kidney injury during hospitalization. On 16-Jul-2021, the patient was discharged from hospital, with oral anticoagulant therapy (Apixaban 5 mg). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pulmonary embolism, acute kidney injury, and rhabdomyolisis, and the outcome of deep vein thrombosis in right lower leg, lost consciousness and traumatic fall was not reported. This report was serious (Hospitalization Caused / Prolonged, and Life Threatening). This case, from the same reporter is linked to 20210820514.; Sender''s Comments: V0: 20210835633-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Pulmonary embolism, Acute kidney injury, Deep vein thrombosis, Lost consciousness, Rhabdomyolysis, Traumatic fall. 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: 1594423 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Blood test, Chest X-ray, Echocardiogram, Electrocardiogram, Venogram
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Obesity
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: Echocardiogram; Result Unstructured Data: Normal; Test Date: 20210729; Test Name: EKG; Result Unstructured Data: Atrial Fibrillation; Test Date: 20210729; Test Name: Chest X-ray; Result Unstructured Data: Normal; Test Date: 20210729; Test Name: Blood test; Result Unstructured Data: Normal; Test Date: 20210729; Test Name: Venogram; Result Unstructured Data: Normal.
CDC Split Type: USJNJFOC20210835730

Write-up: ASYMPTOMATIC ATRIAL FIBRILLATION; This spontaneous report received from a consumer concerned a 57 year old white, not Hispanic or Latino male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: obesity. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1802072 and expiry: UNKNOWN) dose was not reported, frequency one total, administered on 11-MAR-2021 on left deltoid for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the patient went for a well check up and the EKG (Electrocardiography) showed atrial fibrillation, the patient visited to emergency room, as the patient experienced asymptomatic atrial fibrillation, was hospitalized and treated with some type of medication (beta blocker) and was fine. Laboratory data included: Blood test (NR: not provided) Normal, Chest X-ray (NR: not provided) Normal, EKG (Electrocardiography) (NR: not provided) Atrial Fibrillation, Echocardiogram (NR: not provided) Normal, and Venogram (NR: not provided) Normal. The number of days hospitalized was not reported. Patient was on medication to keep to his heart in check and had an appointment on the 2nd week of September with the cardiologist. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from asymptomatic atrial fibrillation. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210835730-Covid-19 vaccine ad26.cov2.s-asymptomatic atrial fibrillation. 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: 1594427 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? 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: 20210812; Test Name: Body temperature; Result Unstructured Data: 101.2 F; Test Date: 20210817; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210836071

Write-up: FEVER; This spontaneous report received from a patient concerned a 23 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 21-SEP-2021) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-AUG-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.2 F. On 17-AUG-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever. This report was non-serious.


VAERS ID: 1594431 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dyspnoea, Hyperhidrosis, Nausea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Fibromyalgia; Graves'' disease (rapid heart beat because of Grave''s disease.); Smoker (She smokes a pack a day)
Preexisting Conditions: Comments: The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210837256

Write-up: SWEATING; SHORT OF BREATH; CHILLS; VERY NAUSEOUS; This spontaneous report received from a patient concerned a 54 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: graves disease, no alcohol use, smoker, and fibromyalgia, and other pre-existing medical conditions included: The patient had no drug abuse or illicit drug usage. The patient experienced drug allergy when treated with hydromorphone hydrochloride, and morphine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: 21-SEP-2021) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Negative. On 09-APR-2021, the patient experienced sweating. On 09-APR-2021, the patient experienced short of breath. On 09-APR-2021, the patient experienced chills. On 09-APR-2021, the patient experienced very nauseous. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sweating, short of breath, chills, and very nauseous on 17-APR-2021. This report was non-serious.


VAERS ID: 1594457 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-08-15
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest pain, Fatigue, SARS-CoV-2 test, Scan, Upper-airway cough syndrome
SMQs:, Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: FLONASE [MOMETASONE FUROATE]; ALLOPURINOL; VERAPAMIL; LORAZEPAM; SEREVENT
Current Illness: Alcohol use (Couple of wine glasses every night); Anxiety; Asthma (Use serevent inhaler and twist inhaler Flonase for nose, 2 sprays in each nostril once a day.); Blood pressure; Exercise induced asthma; Gout; Non-smoker
Preexisting Conditions: Comments: The patient was not a drug abuse or illicit drug user.
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: Scan; Result Unstructured Data: Unknown; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210837701

Write-up: CHEST PAIN; FATIGUE; FEELS WEAK; POST NASAL DRIP; This spontaneous report received from a consumer concerned a 75 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: exercise induced asthma, gout, blood pressure, anxiety, alcohol user, asthma, alcohol user, and non-smoker, and other pre-existing medical conditions included: The patient was not a drug abuse or illicit drug user. The patient experienced drug allergy when treated with acetylsalicylic acid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, 1 total administered on 09-AUG-2021 for prophylactic vaccination. Concomitant medications included lorazepam for anxiety, mometasone furoate for asthma, salmeterol xinafoate for asthma, verapamil for blood pressure, and allopurinol for gout. On 15-AUG-2021, after receiving the vaccine, the patient started having post nasal drip from the nose. It was clear, but it was very heavy and everywhere then there was mucus. On 16-AUG-2021, the patient experienced chest pain and the patient thought it was because of anxiety and took lorazepam which did not work, and was hospitalized and had to stay in emergency room for observation. The patient stated that lots of scans were done, received IV and then was released on 17-Aug-2021. The laboratory result for lots of scan was unknown. The Consumer stated that they tested him for Covid-19 and it came back negative. . On an unspecified date, the patient experienced fatigue, and feels weak, the patient was asked if the symptoms were gone the patient stated that the patient was feeling weak. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chest pain and post nasal drip on 17-AUG-2021, the patient had not recovered from feels weak, and the outcome of fatigue was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210837701-covid-19 vaccine ad26.cov2.s -Chest pain. 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: 1594458 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood test, Fall, Fatigue, Headache, Heart rate, Syncope, X-ray
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210409; Test Name: X-ray; Result Unstructured Data: Not reported; Test Date: 20210409; Test Name: Heart rate; Result Unstructured Data: unknown; Test Date: 20210409; Test Name: Blood test; Result Unstructured Data: Not reported
CDC Split Type: USJNJFOC20210837758

Write-up: FAINTING; SHE FELL AND HIT HER HEAD ON WALL; LAID DOWN FOR A FEW HOURS AND WAS SCARED TO MOVE; HEADACHE; FELT TIRED; This spontaneous report received from a consumer concerned a 34 year old female of unknown ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. Patient was not pregnant at the time of vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A and expiry: unknown) dose was not reported, 1 total, administered to left arm on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021 (reported as following morning), patient experienced a fainting. She woke up to go to the restroom and when she came out of the bathroom, she fell. She hit her head on the side of the wall as she fell, and immediately went to the emergency room. Patient received X-ray (result not reported), heartbeat, and lungs were evaluated as well as blood tests (result not reported). They determined that she would not faint again and discharged her. After she returned home, she experienced headache and felt tired. She laid down for a few hours and was scared to move. On the day of reporting, she was no longer having any side effects. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fainting, she fell and hit her head on wall, headache, laid down for a few hours and was scared to move and felt tired. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210837758- Covid-19 vaccine ad26.cov2.s- Fainting. 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: 1594472 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Malaise, SARS-CoV-2 test
SMQs:, 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:
Current Illness: Immunocompromised
Preexisting Conditions: Comments: patient was on immunosuppressant medication.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: COVID-19 virus test; Result Unstructured Data: Not reported
CDC Split Type: USJNJFOC20210839193

Write-up: SYMPTOMS GOT WORSE; NOT FEELING TOO GREAT; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: immunocompromised, and other pre-existing medical conditions included: patient was on immunosuppressant medication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On AUG-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Not reported. On an unspecified date, the patient experienced symptoms got worse, and not feeling too great. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the not feeling too great and symptoms got worse was not reported. This report was non-serious.


VAERS ID: 1594489 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-08-06
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Burning sensation, Cold sweat, Disorientation, Hot flush, Pain, Pain assessment, Paraesthesia, Pruritus, Ultrasound scan, Varicose vein, Vein discolouration, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Current Illness: Alcohol use (8 to 9 drinks per week); Alpha-gal allergy; Cigarette smoker (1 pack to 1/2 a pack per day); Sulfonamide allergy (occurred when very young.)
Preexisting Conditions: Medical History/Concurrent Conditions: Tick bite; Comments: The patient had no history of drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: Ultrasound scan; Result Unstructured Data: no clots in legs; Test Date: 20210816; Test Name: Blood test; Result Unstructured Data: not reported; Test Date: 20210818; Test Name: Pain scale; Result Unstructured Data: 7 out of 10
CDC Split Type: USJNJFOC20210840588

Write-up: HOT FLASHES; SHOOTING PAIN IN DIFFERENT AREAS; BLURRY VISION AND CANNOT READ AT CERTAIN DISTANCE; BLOOD VESSELS BENEATH BOTH KNEES AND FEET (LEFT LEG APPEARS WORSE THAN RIGHT LEG); PURPLE-LIKE VEINS; TINGLING IN BOTH THE LEGS/ TINGLING IN HANDS; ITCHING OF RIGHT AND LEFT LEGS; COLD SWEATS; DISORIENTED; BURNING OF RIGHT AND LEFT LEGS/ BURNING SENSATION IN BOTH ARMS; This spontaneous report received from a patient concerned a 46 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: tick bite, and concurrent conditions included: cigarette smoker, alcohol user, alpha-gal allergy, and sulfa allergy, and other pre-existing medical conditions included: The patient had no history of drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: 21-SEP-2021) dose was not reported, administered on 06-AUG-2021 for prophylactic vaccination. Concomitant medications included cetirizine hydrochloride for allergy. On 06-AUG-2021, the patient experienced burning of right and left legs/ burning sensation in both arms. On 06-AUG-2021, the patient experienced disoriented. On 06-AUG-2021, the patient experienced itching of right and left legs. On 06-AUG-2021, the patient experienced cold sweats. Treatment medications included: diphenhydramine hydrochloride. On 16-AUG-2021, the patient experienced blood vessels beneath both knees and feet (left leg appears worse than right leg). On 16-AUG-2021, the patient experienced purple-like veins. On 16-AUG-2021, the patient experienced tingling in both the legs/ tingling in hands. Laboratory data included: Blood test (NR: not provided) not reported, and Ultrasound scan (NR: not provided) no clots in legs. On 17-AUG-2021, the patient experienced blurry vision and cannot read at certain distance. On 18-AUG-2021, the patient experienced hot flashes. On 18-AUG-2021, the patient experienced shooting pain in different areas. Laboratory data included: Pain scale (NR: not provided) 7 out of 10. Treatment medications included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from disoriented, and cold sweats on 06-AUG-2021, had not recovered from burning of right and left legs/ burning sensation in both arms, blood vessels beneath both knees and feet (left leg appears worse than right leg), blurry vision and cannot read at certain distance, hot flashes, itching of right and left legs, and tingling in both the legs/ tingling in hands, and the outcome of shooting pain in different areas and purple-like veins was not reported. This report was non-serious.


VAERS ID: 1595980 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-07-30
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Bell?s palsy


VAERS ID: 1602597 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-27
Onset:2021-06-05
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cerebrovascular accident, Computerised tomogram, Gait disturbance, Grip strength decreased, Hypoaesthesia, Hypotonia, Magnetic resonance imaging, Musculoskeletal disorder, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prestique, Serequel and Lamotrogine.
Current Illness: None
Preexisting Conditions: Insomnia. Foot Pain, situational depression
Allergies: Codine relate. Aloe.
Diagnostic Lab Data: Blood work, Covid test, Cat scan , and MRI was done. It was determined I had had a mild stroke located in the around the top middle of my head to the left.
CDC Split Type:

Write-up: I had a mild stroke. I was typing on my laptop and all of a sudden my fingers were not working. They weren''t pressing the keys. I thought maybe all the gardening I did that day my be contributing, plus I stayed up later after taking my insomnia medicine; so I went to sleep. Next morning, I could not hold my coffee cup and knew something was wrong. Plus I my left side arm & hand could not be used. It just flopped on the table; and left side of face & ear was numb and left leg was walking wonky. I went to the emergency room at the closest hospital.


VAERS ID: 1602608 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-14
Onset:2021-07-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray normal, Chest discomfort, Chest pain, Decreased appetite, Dry throat, Dysphagia, Dyspnoea, Electrocardiogram normal, Heart rate increased, Influenza virus test negative, Insomnia, Lethargy, Palpitations, Red blood cell count increased, SARS-CoV-2 test negative, Throat tightness, Troponin normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (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: Prescription strength Vitamin D
Current Illness: Zero
Preexisting Conditions: Zero
Allergies: Histamine sensitive
Diagnostic Lab Data: - COVID test - negative - Flu test - negative - Troponin test - 0 - ECG - normal - chest X-ray - normal - RBC - slightly up - blood test for inflammatory markers - TBD - d dimer - TBD
CDC Split Type:

Write-up: 4 weeks+ of: - chest pressure - random sharp pains in chest - heart pounding - increase heart rate and blood pressure - difficulty breathing and swallowing - shortness of breath - throat pressure - dry throat and tongue - head pressure (back of head through my ears to my nose and down my throat) - lethargy - loss of appetite - difficulty sleeping


VAERS ID: 1602802 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Asthenia, Back pain, Blood test, Chest pain, Computerised tomogram, Decreased appetite, Dizziness, Electrocardiogram, Fibrin D dimer, Full blood count, Gait disturbance, Headache, International normalised ratio, Metabolic function test, Nausea, Oversensing, Photophobia, Thrombosis, Ultrasound scan, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo-loestrin, Digestive enzymes, multivitamin, green tea extract, VitD3, Concerta, Omeprazole
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Ultrasound on legs, CTA Head with and without contrast, EKG, CBC w/differential, comprehensive metabolic panel, d-dimer fibrinogen, PTT, Protine INR. and follow up blood work and a ultra sound with Vascular Surgeon.
CDC Split Type:

Write-up: Hives, severe headache, severe stomach and chest pains, deep joint and back pain, dizzy, nauseous, loss of appetite, sensitive to light and noise, weak, and 2 weeks later couldn''t walk. went to ER and they found blood clots in left leg.


VAERS ID: 1602859 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Body temperature decreased, Cardiac function test, Disorientation, General physical health deterioration, Hyperhidrosis, Hypothermia, Musculoskeletal disorder, Near death experience, Pulmonary function test, Shock
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: at age 18 he had diarrhea and vomiting from flu shot
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many blood tests for everything imaginable and heart and lung test.
CDC Split Type:

Write-up: profuse sweating, loss of use of limbs, disoriented, temp drop to 85 degrees. Body started to shut down. Hypothermia, shock near death! by minutes if my son didn''t get to the hospital exactly when he did! This was a nightmare and no one could explain it.


VAERS ID: 1602860 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Pyrexia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Fever of 104.9, tachycardia to the 130s, weakness, fatigue, chills.


VAERS ID: 1602862 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Hyperhidrosis, Peripheral coldness, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypoglycaemia (broad)

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

Write-up: The patient was doing well during his observation time and when his time was up and he was being released he started sweating profusely, complained of loss of vision, ringing in ears and was cold to the touch. EMS was called and arrived about 10 minutes later. Patient did not lose consciousness and was communicating well the entire time. BP was normal, BG was normal and when EMS transported the patient his left side of face began to droop. EMS left the facility with the patient at 2:12pm and the patients emergency contact was notified.


VAERS ID: 1602865 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-26
Onset:2021-06-28
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Platlet count drop to


VAERS ID: 1602884 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Dyspnoea, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient began having shallow labored breathing starting 20 minutes post vaccination. Sweating, severe abdominal cramps, and chills. Patient was take by ambulance to local Hospital Emergency Department. Nothing else is know about the outcome. Phone attempt to reach patient shows unregistered voicemail.


VAERS ID: 1602904 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac arrest, Cardiac stress test, Computerised tomogram, Condition aggravated, Echocardiogram, Fibrin D dimer increased, Hypertension, Renal failure, Thrombosis
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Hypertension (narrow), Cardiomyopathy (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-07-27
   Days after onset: 104
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Welbutrin
Current Illness: none
Preexisting Conditions: Hypertension
Allergies: no
Diagnostic Lab Data: HIgh D-dimer, CT scans, echo heart, stress test and others.
CDC Split Type:

Write-up: Patient developed high D-dimer and blood clots immediately after vaccination. Kidney failure followed shortly thereafter. Went into hypertensive cardiac arrest approximately 3 weeks later. All started with vaccination.


VAERS ID: 1602916 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0000000 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: EKG Blood Glucose
CDC Split Type:

Write-up: Syncope


VAERS ID: 1602975 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Ischaemic stroke, Magnetic resonance imaging head abnormal, Thalamic infarction
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
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: none
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: MRI Brain: Small acute/subacute infarct in the right thalamus.
CDC Split Type:

Write-up: Small right thalamic ischemic stroke (proven on MRI) with left-sided total body numbness.


VAERS ID: 1608196 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

Write-up: headache, nausea/vomiting, low grade fevers, malaise, myalgias


VAERS ID: 1617395 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Chills, Differential white blood cell count, Electrocardiogram normal, Feeling hot, Full blood count, Headache, Heart rate increased, Hyperhidrosis, Hypoaesthesia, Metabolic function test, Pallor, Tachycardia, Thyroxine free, Troponin I
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, 200 mm Hydroxychlorquine
Current Illness: none
Preexisting Conditions: Dermatomyositis
Allergies: Sulfa drugs, latex, prednisone, polyethelyne glycol
Diagnostic Lab Data: CBC with Differential, comprehensive Metabolic Panel TSH with Reflex Free T4, Tropnin I, Blood , EKG 12 lead All normal.
CDC Split Type:

Write-up: At 3:30 p.m. August 15, I was outside getting my grill ready to cook dinner. I felt headache and heart beating rapidly. I wear a fitbit Inspire HR. My heart rate is usually 60 bpm at rest. It was up to 87. I finished cooking, and notice heart rate now at 89BPM. I cleaned up, went inside, put dinner away. I was getting chills. Went to bed at 7:00 P.M at 11:00 P.M. my hear rate had sky rocketed to 117 to 124 BPM I was extremely hot, it felt as my blood was boiling. I was so numb, I could not get my phone to call 911. At 5:00 a.m 8/16 my alarm went off for work. I was sweating, heart rate at 117. My friend was called, she picked me up and took me Emergency room, where I was admitted for heart palpitations due to Covid 19 vaccine. After laying there, I was discharge at 7:30 a.m range with heart rate of 78 BPM. To date, 8/19/21 My heart rate is fluctuating, from 78 to 113 BPM and does not stabilize.


VAERS ID: 1617415 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Diabetes Type 2 Past Liver Cancer/Surgery
Allergies: none the patient was aware of
Diagnostic Lab Data: BP: 133/99 and 155/99
CDC Split Type:

Write-up: Patient received vaccine with no complications... then about 15 minutes later, he began to develop dizziness, high blood pressure, sweating


VAERS ID: 1617482 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Back pain, Fatigue, Migraine, Nausea, Psychogenic seizure
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Woke up due to pseudo seizure, migraine like headache, unbearable lower back pain, fatigue, and nausea


VAERS ID: 1617581 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Heavy menstrual bleeding, Thrombosis, Ultrasound scan normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Corn
Diagnostic Lab Data: Blood work normal-4/10/21 Ultrasound normal-4/10/21
CDC Split Type:

Write-up: Extremely heavy period with large blood clots


VAERS ID: 1617660 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Hospital performed a Covid-19 test 8/22/21 and patient should receive results on 8/24/21
CDC Split Type:

Write-up: patient received her Covid-19 vaccination (Janssen) on 8/20/21 around 1:30pm and at around 10:30pm began experiencing nausea, vomiting, headache, and fatigue. Vomiting ended on 8/20-8/21 however other symptoms continued until she went to Hospital on 8/22/21. Hospital prescribed toradol for her headache and ondansetron for the nausea.


VAERS ID: 1617679 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-06
Onset:2021-08-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anticoagulant therapy, Bilevel positive airway pressure, Blood pressure abnormal, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Fatigue, Fibrin D dimer, Haematemesis, Haematochezia, Malaise, Nausea, Pulmonary embolism, Renal infarct, SARS-CoV-2 test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal haemorrhage (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Hypertension (broad), Cardiomyopathy (broad), Renovascular disorders (narrow), Respiratory failure (broad), 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Suboxone gabapentin furosemide
Current Illness: None
Preexisting Conditions: History oxycodone addiction
Allergies: NKDA
Diagnostic Lab Data: CT D Dimer
CDC Split Type:

Write-up: On 8/15/21 patient began to feel sick with malaise/nausea/vomiting gasping for air. He was driving and had to stop frequently to rest. He began to vomit blood as well as seeing blood in his stool. At one of his stops he was having trouble breathing and emergency called for him. Arrive to ER Spo2 in the 70''s. Patient required Optiflow and is still currrently on 80% 8LPM. Covid test negative. Antibotics started then stopped with CT Chest resulted Multi pulmonary emboli bilaterally as well as possible Renal infarct as well as bilateral DVT''s. Heparin drip started. Pt. continues to need Bipap and medications for BP.


VAERS ID: 1617814 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-05
Onset:2021-03-22
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Electromyogram, Facial paralysis, Laboratory test, Magnetic resonance imaging head, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 25mg BID and Extra Strength Tylenol
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: CT of brain, MRI of brain, labs and EMG
CDC Split Type:

Write-up: Bilateral Bells Palsy. I had vaccine shot on 3/5/21. I woke up on 3/22/21 with right sided facial paralysis. Went to ER. 5 days later I also had paralysis on the left side of my face. It has been 5 months and I still have left sided paralysis. I cannot close my mouth, close my left eye, cannot move my eyebrow,, drool, no gag reflex. I have lost 10 pounds since eating and drinking is difficult.


VAERS ID: 1618510 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse food reaction, Anxiety, Chest discomfort, Dyspnoea, Fatigue, Feeling abnormal, Flushing, Migraine, Neurological symptom, Palpitations
SMQs:, Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Strong reactions to foods and symptoms in line with MCAS. Daily migraines, severe brain fog, chest tightness, difficulty breathing, and fatigue. After consumption of certain foods, severe brain fog, head rush, anxiety, heart palpitations, and flushing. All symptoms never experienced before vaccine. I have experienced migraines every day for the past two months now in addition to extreme fatigue, and can only eat a limited number of foods without severe reaction.


VAERS ID: 1619164 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Cold sweat, Confusional state, Delirium, Differential white blood cell count normal, Dyspnoea, Electrocardiogram normal, Fatigue, Fear, Full blood count normal, Metabolic function test normal, Nausea, Pain, Pyrexia, Swelling, Syncope, Troponin I normal, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing, protein powder.
Current Illness: None.
Preexisting Conditions: Heart murmur/arrhythmia, not fully diagnosed, currently waiting for followup appointment. Doctors seen think it''s most likely not a problem.
Allergies: None, except maybe avocado.
Diagnostic Lab Data: At the ER they performed (~7:00-7:30am): - CBC with differential - Comprehensive Metabolic Panel - Extra Gold Top Tube - Extra Green Top Tube - Extra Lavender Top Tube - Troponin 1 - ECG 12 Lead
CDC Split Type:

Write-up: Extreme tiredness, fever and cold sweats during the night. I got up to use the bathroom (~5:30am), had lots of nausea. After using, I stood and started to make way to bedroom. Nausea became intense, pain and tightness swelled through my torso as well. Breathing became tight, vision was fading, and I was losing balance. My wife heard a thud from the bedroom and came out to find me collapsed against the wall, covered in cold sweat, and delirious. I don''t remember falling or passing out, I remember her concerned voice and her dabbing my face with a wet cloth. I was very confused, frightened. After getting me seated okay couch and talking through what happened, my symptoms were very similar to a heart attack, which is a personal concern of mine, so she took me to the ER (~6:15am). At the ER they performed (~7:00-7:30am): - CBC with differential - Comprehensive Metabolic Panel - Extra Gold Top Tube - Extra Green Top Tube - Extra Lavender Top Tube - Troponin 1 - ECG 12 Lead All tests came back within normal limits. Doctor believes it was Vasovagal syncope. Current outcome is near full recovery (as of 7:00pm 8/22).


VAERS ID: 1619166 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram head, Full blood count normal, Metabolic function test, Muscular weakness, Red blood cell sedimentation rate normal, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Head CT negative - 8/20/2021 MRA/MRV - negative - 8/22/2021 CBC, CMP, ESR, CRP wnl 8/22/2021
CDC Split Type:

Write-up: full body tremors, left-sided muscle weakness - ongoing and currently 10 days post vaccine


VAERS ID: 1623373 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-24
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac failure, Computerised tomogram, Dizziness, Echocardiogram abnormal, Electrocardiogram, Hyperhidrosis, Intracardiac thrombus, Magnetic resonance imaging heart, Muscular weakness, Scan with contrast
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid Effexor Lymictal
Current Illness: None
Preexisting Conditions: hypothyroidism clinical depression
Allergies: None
Diagnostic Lab Data: I have had a CT scan (with, and without contraast), multiple EKGs, echocardiogram, and a cardiac MRI.
CDC Split Type:

Write-up: I was on the beach and was suddenly overwhelmed with muscle weakness, excessive sweating, light headedness, and other symptoms. Symptoms continued for the next two months, until I finally went to the emergency room and they admitted me for heart failure. I had never had any heart-related symptoms. I do not have a history of hypertension or coronary artery disease (still don''t). They found a blood clot in my heart during an echocardiogram.


VAERS ID: 1623397 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Electric shock sensation, Insomnia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine: 50mcg every other day. 25mcg every other day Cytomel: 5 micrograms daily
Current Illness: Hashimoto?s Thyroiditis Possible Meniere?s Iron deficiency
Preexisting Conditions: Hashimoto?s Thyroiditis Possible Meniere''s
Allergies: Prednisone
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Have been experiencing insomnia since August 13 along with brain zaps/shivers that keep jolting me awake upon falling asleep. Also experiencing body tremors or vibrations that can be felt by me but are not seen by others. It is still ongoing.


VAERS ID: 1623462 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure decreased, Heart rate increased, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: 21 yo Mwith no PMHX accompanied by mother for single dose J&J vaccine at approximately 11:50am. Approximately 30 seconds after vaccine administration, patient experienced syncopal episode with persistent orthostatic vital sign changes. Brief LOC witnessed, patient did not fall over. When patient moved from sitting to laying position, BP dropped and HR elevated slightly. Patient denies n/v, HA, dizziness, visual changes, tinnitus. Patient denies allergies or previous episode of syncope. Condition improved with time. Vitals laying BP 100/61, Pulse 53, O2 91%, RR 12, sitting up BP 100/50, Pulse 70, O2 98%, RR12. EMS called and pt transferred to ER for medical eval.


VAERS ID: 1623555 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Unknown  
Location: Ohio  
Vaccinated:2021-05-07
Onset:2021-05-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / UN

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

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

Write-up: Excruciating headache for 45 days, continuous hearing heart beat in left ear


VAERS ID: 1623568 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-03-06
Onset:2021-03-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / SYR

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Headache, Myalgia, Thrombosis, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament 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: Embrel , fexophenadine
Current Illness:
Preexisting Conditions: Psoriatic arthritis
Allergies:
Diagnostic Lab Data: Multiple ER trips, my doctor has sent me to multiple specialists. Hematology oncology, cardiologist, Immunologist, neurologists.
CDC Split Type:

Write-up: 1) blood clots in left thigh, sore muscles, blurry vision, dizzy when sitting up after laying down, blood clots in left forearm, headache. Some of these symptoms are still present.


VAERS ID: 1623573 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-18
Onset:2021-06-07
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A OR 2013 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood fibrinogen normal, Blood folate, Contusion, Gene sequencing, HIV test negative, Heparin-induced thrombocytopenia test, Hepatitis B test negative, Hepatitis C test negative, Immunoglobulin therapy, Platelet count decreased, Platelet transfusion, Prothrombin time normal, Vitamin B12
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: PT, PTT, fibrinogen normal hemolytic panel normal vitamin B12, folate hepatitis B, C and HIV negative serotonin release assay (standard type for HIT) negative
CDC Split Type:

Write-up: Patient has no significant medial problems. He received 1st dose of vaccine on 5/19/21. Since 6/2/21 noted bruises, on 6/7/21 came to ED and fount to have platelets 5000/ul. He received 3 units of platelets, IVIG and started treatment with dexamethasone


VAERS ID: 1623670 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-26
Onset:2021-08-20
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0431A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: No
Preexisting Conditions: HPV-2
Allergies: No
Diagnostic Lab Data: BLOOD CLOT ON RIGHT LEG .
CDC Split Type:

Write-up: DVT DEEP VEIN THROMBOSIS; BLOOD THINNERS AND FOLLOW UP CARE WITH PHYSICIAN. OUTCOME, PISAED OFF AND READY TO SUE.


VAERS ID: 1623783 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-14
Onset:2021-06-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ascites, Discomfort, Endometrial hyperplasia, Flank pain, Nausea, Ovarian enlargement, Pain, Pelvic pain, Ultrasound abdomen abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Reproductive premalignant disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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? 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: latex sensitivity with prolonged exposure
Diagnostic Lab Data: Ultrasound 6/20, showed thickened endometrium and excess fluid in the abdominal cavity.
CDC Split Type:

Write-up: Three days after receiving the vaccine I began having pelvic pain. The pain originated on the right side, near my right ovary. Ovary felt enlarged to palpation. Pain increased with bending over or crouching. Pain worsened when lying on the side of the opposite ovary, due to feeling of "heaviness." Pain improved with resting. Two days later the pain migrated to my left side, and left ovary also felt enlarged. Pain was a 6/10. Intermittent nausea. No vomiting, bleeding, discharge, shortness of breath, chest pain, fevers, chills, diarrhea, or changes in urine or bowel habits. No concerns for STD exposure. After three full days (thursday evening through sunday evening, 6/17-6/20), the pain subsided with ovulation.


VAERS ID: 1623889 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test normal, Diarrhoea, Gait disturbance, Hypotension, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: shaking uncontrollably in sleep, barely could walk from shaking, low b/p, fever, severe stomach pain, diarrhea,


VAERS ID: 1623953 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-02
Onset:2021-08-10
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Cerebral disorder, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bupropion, buspirone
Current Illness: Presumably had COVID shortly after J&J vaccine (URI symptoms and husband tested positive for COVID but she never was tested).
Preexisting Conditions: Morbid obesity BMI 40
Allergies: None
Diagnostic Lab Data: CTA Venous Sinus 8/10/2021 1. Filling defect in peripheral aspect of right transverse sinus is concerning for dural venous sinus thrombosis. 2. Diminutive appearance of left transverse sinus likely related to congenital hypoplasia. 3. No evidence of acute intracranial hemorrhage or edema on unenhanced CT.
CDC Split Type:

Write-up: Cerebral venous sinus thrombosis


VAERS ID: 1623996 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 021A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Eye irritation, Eye pain, Fatigue, Hyporesponsive to stimuli, Immediate post-injection reaction, Impaired work ability, Laboratory test, Lacrimation increased, Migraine, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Dr. ordered labs and IVF. He responded to anti-emetic phenergan and was sent home.
CDC Split Type:

Write-up: "Instantly" after getting the vaccination, pt. described his left eye "felt on fire". His eye started watering . He later reported he had an "instant" migraine. MD was called to evaluate. He was having no SOB, vitals were stable x 30 minutes. He said he felt well to go home. After he was home, he felt fatigued, SOB, had some chest pain, eye pain and migraine. He went to bed and slept the night. In the AM he awoke, still fatigues, eye pain. Went to work and then sent home. He spiked a fever to 102F. His wife reported he was "barely responsive". He was taken to ED.


VAERS ID: 1624004 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-16
Onset:2021-08-04
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Asthenia, Bilevel positive airway pressure, COVID-19, Diarrhoea, Dyspnoea, Hypotension, Lung infiltration, Nausea, Oxygen saturation decreased, Positive expiratory pressure therapy, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (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: albuterol alprazolam, amitriptyline, buspirone, cyclobenzaprin, insulin aspart, insulin detemir, levothyroxine, lidocaine topical, naproxen, olanzapine, pantoprazole, venlafaxine
Current Illness:
Preexisting Conditions: Diabetes, hypothyroidism, hyperlipidemai, gastroparesis, pancreatitis
Allergies: Cipro, Darvocet, Phenergan, Reglan
Diagnostic Lab Data: SAR COV2 Positive on 7/29/21
CDC Split Type:

Write-up: She completed COVID vaccine on 03/16/2021. 8/4/21: She originally presented at an outside hospital on 8/1/21 and was transferred to another facility on 8/4/21. Her symptoms are nausea, diarrhea, weakness, and SOB. She noticed no improvement, and was hospitalized at the Hospital on 8/4/21. CTA chest shows diffuse bilateral infiltrates. 8/9/21: on BiPAP with 100% FiO2, completed 5 days of remdesivir, continuing steroids and baricitinib 8/17/21: on HHFO 30L, desats on exertion, hypotensive episode upon sitting up 8/23/21: on heated high-flow, SOB persists, still admitted


VAERS ID: 1624075 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-08
Onset:2021-07-09
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Dizziness, Malaise, Nausea, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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:
Current Illness:
Preexisting Conditions: HTN
Allergies: NKA
Diagnostic Lab Data: covid test
CDC Split Type:

Write-up: ED feeling sick, lightheaded, N/V/D, weak


VAERS ID: 1624078 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-08-22
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Dyspnoea, Lung infiltration, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Tachycardia
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (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: Moderate episode of recurrent major depressive disorder Malignant melanoma of skin of left lower leg Obesity
Allergies: Penicillins
Diagnostic Lab Data: Positive for SARS-CoV-2 RNA by PCR Abnormal E Gene Ct cycles 20.4 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. N2 Gene Ct cycles 21.7 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. Resulting Agency MGHL Specimen Collected: 08/22/21 17:45 Last Resulted: 08/22/21 18:37
CDC Split Type:

Write-up: Patient is a 39 y.o. male who is Covid vaccinated, who presents today with shortness of breath has been ongoing for last week. He has had a 2-day history of loss of taste and smell. He now is having dyspnea at rest. He endorses multiple other viral symptoms. On exam, he is tachycardic and has a low fever. His work of breathing has slightly increased. Lungs are clear with good breath sounds. IV was started. Labs were drawn. He was treated with oral Tylenol. X-ray reveals infiltrates to suggest pneumonia. Unfortunately, his Covid screen came back positive. Certainly, his clinical symptoms are most suggestive of Covid infection. Given the x-ray findings, however I am concerned about a bacterial suprainfection, thus he was started on cefdinir and Zithromax. After hydration and antiparesis here, the patient does feel improved. I discussed with him the diagnosis. I discussed with him the use of a pulse oximeter. I think at this point he can be discharged, but understands that he needs to return for worsening symptoms.


VAERS ID: 1624081 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-06-04
Onset:2021-08-08
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Atrial fibrillation, Cardiac monitoring, Cardiac stress test, Laboratory test
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sunoco be 4mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I?ve been in the emergency room 7 times in the last two weeks for cardiac related issues, and have done a stress test, and scheduled for a cardiac ablation. Too many tests and results so far to list here.
CDC Split Type:

Write-up: On August 8th I was taken to the Emergency Room via ambulance because I suddenly went in to Atrial Fibrillation RVR. After receiving electrolytes, and diltiazem I was released. I was still in afib. I was prescribed Diltiazem and baby aspirin that I have been taking daily for two weeks. I have undergone a stress test, currently wear an event monitor called MCOT (mobile cardiac outpatient telemetry). I have a caravan scheduled for 10/21, and a cardiac ablation scheduled for 10/28.


VAERS ID: 1624085 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-04
Onset:2021-08-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2020A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatinine normal, Blood glucose normal, Blood lactic acid, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone decreased, Chest X-ray normal, Electrocardiogram abnormal, Fatigue, Feeling hot, Haematocrit normal, Haemoglobin normal, Liver function test normal, Nitrite urine absent, Palpitations, Platelet count normal, Procalcitonin normal, SARS-CoV-2 test negative, Sinus tachycardia, Troponin normal, Urine leukocyte esterase, White blood cell count normal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Dehydration (broad), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: Varicella
Other Medications: ? Vitamin C 250 mg daily. ? Vitamin D 1000 units daily. ? Flexeril 5 mg p.o. b.i.d. ? Krill oil 1 capsule daily. ? Magnesium 1 tablet daily. ? Multivitamin daily. ? Trileptal 75 mg b.i.d., however she is supposed to increase this up to 150
Current Illness: ? POTS ? Mast cell degranulation. ? Chronic right leg pain.
Preexisting Conditions:
Allergies: ? Azithromycin. ? Gluten. ? Latex.
Diagnostic Lab Data: IMAGING: The patient?s chest x-ray was read by radiologist as normal. EKG on my review shows sinus tachycardia at a rate of 128, QT interval is 467, no ischemic changes appreciated. LABORATORY DATA: White count of 8, hemoglobin 13, hematocrit 40, platelets 240. Sodium 140, potassium 3.7, creatinine 0.7, glucose 96. LFTs are all within normal limits. TSH is normal at 1.3. Troponin negative. Procalcitonin negative. Lactic acid is 2. Urine: Negative nitrites, negative leukocytes. Rapid COVID negative.
CDC Split Type:

Write-up: A very pleasant 18-year-old female who lives at home with her parents. Her history is pertinent for chronic right leg pain due to complex regional pain syndrome, postural tachycardia syndrome (POTS), and questionable mast cell degranulation. She has been in her usual state of health. She is looking forward to going to The University of New England for college this fall. They require COVID vaccination. Family considered their options. They opted to choose the Johnson & Johnson vaccine as it is a single shot and the patient has had adverse reactions with prior vaccines according to the mom. The patient had her J & J vaccine early in the morning. It was given at approximately 9 a.m. The patient went home. Shortly thereafter she started feeling very tired, in fact had to take a nap. She felt hot, but when the temperature was measured at home, she was afebrile. Then later evening she started developing significant pounding in her chest.


VAERS ID: 1624108 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Electrocardiogram, Hypoaesthesia, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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: Aspirin-Dipyridamole ER 25/200 mg Cap ER 12hr TAKE 1 CAPSULE BY MOUTH TWICE A DAY azaTHIOprine 50 mg Tab TAKE 2 TABLETS BY MOUTH EVERY DAY Lantus SoloStar 100 UNIT/ML Solution Pen-injector INJECT 52 UNITS UNDER THE SKIN AT BEDTIME Losartan
Current Illness: NA
Preexisting Conditions: Diabetes, Crohn''s disease, hx TIA
Allergies: Codeine
Diagnostic Lab Data: 8/23/21 EKG 8/23/21 CMP
CDC Split Type:

Write-up: Day 2 post vaccine SOB and Chest tightness, resolved Day 3 post vaccine L facial numbness Patient called clinic at 4:30 Day 3 post vaccine and was advised to go to ER, pt did not go Day 6 post vaccine patient had office visit and MD advised pt to go to ER for further work up


VAERS ID: 1624298 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2029219 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Bradycardia, Chest pain, Electrocardiogram, Fatigue, Night sweats, Pain
SMQs:, Arrhythmia related investigations, signs and symptoms (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: None
Current Illness: None
Preexisting Conditions: N/a
Allergies: No known allergies
Diagnostic Lab Data: EKG done 08/23/21 at the same site of the vaccine. EKG findings, bradycardia with possibility of LVH r/t voltage on specific EKG electrodes.
CDC Split Type:

Write-up: Transient Chest pain the following morning followed by weakness fatigue, body aches and sweating during sleep.


VAERS ID: 1624324 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-07
Onset:2021-04-26
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Chronic inflammatory demyelinating polyradiculoneuropathy, Dysgeusia, Electromyogram, Hypoaesthesia, Immunoglobulin therapy, Lumbar puncture, Magnetic resonance imaging, Muscle twitching, Myokymia, Paraesthesia, Taste disorder
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), 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: Losartan Vitamin D B12 Iron Zinc Magnesium Green Superfoods Vitamin C Echinacea Ashwagandha
Current Illness: None
Preexisting Conditions: left bundle branch block high blood pressure
Allergies: Penicillin
Diagnostic Lab Data: Blood Tests (May) Electromyography (May) Lumbar Puncture (May) MRI (5/14/21)
CDC Split Type:

Write-up: Increase numbness starting at toes and fingers and spreading up to legs, arms, and radiating through the torso. Face began twitching and taste was impacted. Diagnosis: Myokymia (face) Paraesthesia Dysgeusia Chronic inflammatory demyelinating polyneuropathy (CIDP) Treatment: Gabapentin IVIG


VAERS ID: 1624326 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-10
Onset:2021-08-22
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysarthria, Head injury, Syncope, Unresponsive to stimuli, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinipril 10mg, Premarin 5mg,
Current Illness: Fainted & Paased out SUDDENLY; hit Head & on concrete HARD & back issues. Fire Dept says I have a concussion but because of Delta outbreak, seek medical attention from my Primary Care Physician.
Preexisting Conditions: Hypertension
Allergies: Penicillin, (rash) **Fainted & hit head on concrete 08/22/21 is the event why I''m reporting.
Diagnostic Lab Data: Appointment is 08/25/21 -tentively scheduled.
CDC Split Type:

Write-up: Vaccinated on 08/10/21, mild symptoms until yesterday (08/22/21), standing outside ''under carport'' & COMPLETELY just -fainted (passed out), hit head on concrete HARD (fell straight back) w/eyes open BUT NOT responding, was awaken (speech slightly slurred & head spinning plus I believe I''ve fractured or bruised my lower back/butt bone when I hit concrete so hard. Seemed medical attention (@ fire department & was told ambulance was gone (because of the Delta variant & the OVER STRESSED hospitals- I should see my Primary Care Physician) but I would need a CT/MRI done.


VAERS ID: 1625029 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-21
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Collagen disorder, Joint range of motion decreased, Magnetic resonance imaging abnormal, Muscular weakness, Pain, Pain in extremity, Tendon disorder, X-ray abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pain at injection site, chills, fever
Other Medications: Synthroid, cytomel, monolucast, atorvastin, doluxodine, vitamin D, cranberry, tizanadine, Tramadol, melatonin,
Current Illness: Fibromyalgia, osteoarthritis,
Preexisting Conditions:
Allergies: Sulfa Seasonal hay fever
Diagnostic Lab Data: MRI; X-ray; Physical exam by orthopedist
CDC Split Type:

Write-up: Sore and weak LEFT ARM, shoulder, back and chest. I had an X-ray and MRI that shows nothing more than desecration of collagen and tendinosis. But, I did nothing to injure arm. Within a few weeks, the same symptoms began in my right arm. I cannot lift either arm without extreme pain.


VAERS ID: 1625265 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Electrocardiogram, Flushing, Immediate post-injection reaction, Pain in extremity, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Hypersensitivity (narrow), 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: Couldn''t pick up a glass of water 48 hours after flu mist. Had to call off work. 38 years old. May 2011. I don''t have the brand
Other Medications: Hydroxychloroquine
Current Illness: None
Preexisting Conditions: Systemic lupus nephritis
Allergies: Penicillin
Diagnostic Lab Data: Labs came back fine.
CDC Split Type:

Write-up: First 10 seconds immediate swelling. A minute and a half increasing pain in the arm. Next 10 minutes flushed and tingly or loopy systemically. After 15 minutes not flushed but still light feeling. Returned inside the clinic to have blood pressure checked. It was abnormal at 147 something. They advised going to the emergency room. An ambulance came and my blood pressure continued to rise to 157. In ER they did an EKG. Blood pressure continue to rise but heart rate was extremely low in the 40s. Stayed for 4 and 1/2 hours. The highest blood pressure was at 174/86. Lowest heart rate was 40. The doctor tried Xanax but it did not lower much of the blood pressure. It did decrease some to 148 to 164. Heart rate did go up to 50s and 60s but still dropped to 40s. They released me because they had no answers and the labs came back fine. I could not drive because of the Xanax made me feel worse. So I had someone drive me home. I am to follow up tomorrow with my primary care doctor to check my blood pressure and see what else can be done.


VAERS ID: 1625279 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816027 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Fall
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

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

Write-up: Patient Fell on the floor after getting the shot (pt waited in the vaccine room for a while, and he wanted to use to the restroom, he walked out and felt lightheadedness, then he fell on the floor outside the pharmacy). (patient said he has history of felling lightheadedness from a blood draw, and he did not eat any food before the shot. the lightheadedness might be due to that) . We called 911, and I waited with the customers until paramedic comes. (patient was feeling fine during that period).


VAERS ID: 1627140 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-24
Onset:2021-07-23
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20/A2/A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Myalgia, Paraesthesia, Skin burning sensation, Testicular pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: Sumatriptan. when needed for occasional migraines Vitamins; A. E, D, C
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: Penicillin. the last reaction I had was when I was 8 years old
Diagnostic Lab Data: I visited Urgent Care 4-5 days after the symptoms, given medication Gabapentin but it did not work, I have a visit with the Neurologist on September 2.
CDC Split Type:

Write-up: Numbness in my left leg thigh, the area of the Rectus Femorus and the Vastus Lateralis muscles, mild pain in that area and the pain traveling to my left testicle, constant sharp tingling and burn like sensation to the touch of the skin


VAERS ID: 1628008 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Diarrhoea, Laboratory test
SMQs:, Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 50 mcg daily
Current Illness: No
Preexisting Conditions: Hashimotos
Allergies: No known allergies
Diagnostic Lab Data: ER- 8/24 tests pending
CDC Split Type:

Write-up: Diarrhea, lower back pain with no relief of pain with Tylenol and ibuprofen.


VAERS ID: 1628013 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-12
Onset:2021-03-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electroencephalogram, Road traffic accident, Seizure, Skin laceration
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Milk Thistle, Zolpidem, B12, B6, Calcium, Elderberry, Hydrocodone for headaches when needed
Current Illness: Intracranial Hypertension, had a tetanus shot on 3/15/21 for cut on left hand from mandolin
Preexisting Conditions: Intracranial Hypertension
Allergies: Ceclor
Diagnostic Lab Data: CT Scan, EEG, blood tests, continual doctors appointments, 2 ambulance rides due to convulsions
CDC Split Type:

Write-up: on 3/22/2021 at 7:10 am, I had a seizure whilst driving and totaled my car and ended up in the hospital. Have had 5 more seizures since & have never had this in my lifetime.


VAERS ID: 1628092 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: A few minutes after administration the patient felt weak and passed out. His father and I got him in a chair and then he passed out again. At this time we took him down the hall to the ER that is in our building. He was awake when we got to ER. They checked vital and gave fluids. Patient was disharged a few hours later.


VAERS ID: 1628128 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-08
Onset:2021-03-22
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: CSF test abnormal, Electromyogram abnormal, Guillain-Barre syndrome, Nerve conduction studies
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, HLD
Allergies:
Diagnostic Lab Data: EMG/NCS 5/25/21 and CSF studies 6/11/21 supportive of GBS.
CDC Split Type:

Write-up: Patient developed likely Guillain Barre syndrome within a 2-3 weeks of getting his vaccine.


VAERS ID: 1628221 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram, Dysstasia, Feeding disorder, Gait disturbance, Lumbar puncture, Mobility decreased, Paralysis, Positron emission tomogram, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 30 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Prostate Cancer under control
Allergies: None
Diagnostic Lab Data: They did CT scans, PET Scans, spinal tap. You will have to call him for dates
CDC Split Type:

Write-up: Extreme shaking 3 hours after the vaccine. Within one month patient was having difficulty walking, feeling very weak. Was admitted into the hospital end of July/early August. Has been there for over a month. Paralysis. Can barely feed himself, Can not stand, walk or turn over in the bed.


VAERS ID: 1628329 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-23
Onset:2021-07-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Computerised tomogram normal, Discomfort, Dizziness, Fatigue, Headache, Immediate post-injection reaction, Mobility decreased, Nausea, Pain, Photophobia, Pyrexia, Vision blurred
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: buspirone 7.5 mg Lisinipril 20 mg famotidine 20 mg topiramate 25mg euthyrox 150mcg zyrtec Omega 3 Vitamin d
Current Illness: none
Preexisting Conditions: thyroid condition migraines high blood pressure
Allergies: asprin
Diagnostic Lab Data: ct scan blood work both showed no clots or signs of stroke on July 27
CDC Split Type:

Write-up: dizziness within seconds of getting injection: nausea, dizziness, body aches, headache and fatigue onset about 3 hours after the injection next day woke to joint pain and eye sensitivity nausea stopped bu dizzy and body aches continued with no fever. 24 hours after injection same symptoms going on plus low-grade fever and extreme fatigue I could hardly get out of bed and continued with other symptoms nausea and dizziness came and went headaches never go away not even with migraine meds, Tylenol, or ibuprophen. Headaches and eye issues have continued for weeks I did go to the ER my dr was afraid I was having a stroke or a clot I had neither but was given 50 mg Bendryl iv and another medication that starts can not remember which took the headache away for awhile and I was able to sleep, but when I awoke it was back with a vengeance. I have been dealing with it and issues with blurriness and sensitivity to light everyday since the injection and seems like it will never go away sometimes I hide under my covers and relieves the pain and discomfort, but I have a 4 yr old and can not do that. I feel this injection has ruined my life.


VAERS ID: 1628344 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-08
Onset:2021-03-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Laboratory test, Rash, Swelling face, Swollen tongue, Testicular swelling, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HydroxyElite
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I do not have the lab results. Was treated with Prednisone for the swelling
CDC Split Type:

Write-up: Face, tongue and testicles swelled up and had to go to the emergency. A bad rash developed and lasted for about a week and for the week following my swelling at night my legs would experience uncontrollable tremors that would last for about 1 min at a time and happen several times during the night


VAERS ID: 1628383 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-20
Onset:2021-06-15
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Conjunctivitis, Eye disorder, Impaired driving ability, Ocular discomfort
SMQs:, Severe cutaneous adverse reactions (broad), Corneal disorders (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (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: None
CDC Split Type: vsafe

Write-up: Around the middle of June or the beginning of July, I started having problems with my eyes. At first, it was like pink eye in one eye, and then it was both eyes. I went to the ER. I was told that it should clear up on its own. They said it looked like pink eye and they were going to treat it like pink eye. I was prescribed a gel medication but it didn''t do any good. About two weeks later, I was traveling and I couldn''t even drive anymore, I had to pull over. I decided to go to the ER and I was basically told to just deal with it. It feels like someone is poking my eye with a needle. I have never had pink eye or any other infections or problems with my eyes during my whole life.


VAERS ID: 1628556 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-08
Onset:2021-03-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Cough, Dyspnoea, Fatigue, Headache, Influenza virus test negative, Malaise, Respiratory tract congestion, SARS-CoV-2 test negative, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: Flu shot - made me very sick, developed flu symptoms.
Other Medications: albuterol inhaler, albuterol nebulizer solution, symbicort, diclofenac, Flonase, furosemide Lasix, Tylenol, garlic supplement, Mucinex, hydroxyzine HCI, levocetirizine (xyzal), montelukast (singular), omeprazole, triamcinolone acetonide cre
Current Illness: None
Preexisting Conditions: chronic bronchitis, mild COPD
Allergies: flexril, shrimp, egg plant, pollen, mold, grass, pet dander cats, dogs, feathers, Phoma, Stemphylium, Ash, Birch, Elm, Hickory, Maple, Histamine, Dust Mite DF, Dust Mite DP, Mold Mix, Grass Mix, Ragweed, Tree Mix, Weed Mix, Oak Mix, Walnut, Cocklebur, Pig Weed, Plantain, Mosquito, Aspergillus, Botrytis, June/KY Blue grass, Orchard grass, Red Top grass, Timothy grass.
Diagnostic Lab Data: Covid tests: 3/14/21, 4/17/21, 7/30/21, 8/5/21, 8/11/21 -had both rapid and send off tests with negative results for all. Chest x-rays -4/14/21, 4/17/21, 8/3/21, 8/11/21-clear resul
CDC Split Type:

Write-up: After vaccine, that night felt very tired, next day had a bad headache from noon to 7 p.m. On 3/14/21, developed a cough and severe congestion with wheezing in lungs. Went to urgent care facility. Was tested for COVID-19 and flu. Both tests were negative. Given a steroid shot and antibiotics. Followed up with primary care giver, on March 23, 2021, because I wasn''t feeling any better and still had a cough and a lot of congestion, was given Mucinex. Returned to primary care giver, on 4/6/21 because I still wasn''t feeling well and had a cough with wheezing and congestion, and was prescribed amoxicillin 875-potassiumclavulanate 1.25 mg, and more mucinex. - 4/14/21, I went back to my primary care giver at Family Medicine, due to congestion and coughing and not feeling well, and was prescribed albuterol sulfate for my nebulizer and a chest x-ray was done at the clinic and results showed no pneumonia. - On Saturday, 4/17/21, I awoke with severe congestion, coughing, trouble breathing, and wheezing, so I went to Urgent Care. Urgent Care did a covid test and a flu test with a negative result for both. Urgent Care also did a chest x-ray and saw shadows that they thought were pneumonia, so they gave me a steroid shot and Levaquin antibiotics. - On May 4, 2021, I went back to my primary care giver at Family Medicine, due to severe coughing and wheezing again?. and I was prescribed pseudoephedrine and they referred me to an allergist. -I saw the allergist, Doctor L. on May 14, 2021, and I underwent allergy testing that resulted in the need for two allergy shots weekly beginning June 4, 2021. I have the allergy shots every Friday now. -On July 28, 2021, I developed a dry cough. -On July 29, 2021, by mid-day, I was coughing a lot and had a lot of congestion. -I again saw my primary care giver at Regional Medicine on July 30, 2021, and was prescribed Mucinex and a z-pack antibiotics and sent to Family Clinic for a covid test which resulted in a negative result. -On August 3, 2021, there were no improvements, I actually felt worse, so I went back to my primary care giver and a chest x-ray was administered with a negative result for pneumonia, was prescribed Augmentin antibiotics and steroids for what they thought could be a sinus infection that was causing drainage that caused coughing and congestion. -On August 5, 2021, I still did not feel any better, so I was seen at my primary care giver, Family Medicine and they sent me to Family Clinic, for a covid test which resulted with a negative result, so I was prescribed Levaquin antibiotics and another steroid. -On August 11, 2021, I was still sick with extreme coughing and congestion, so I underwent another covid test at Family Clinic, with a negative result and the care giver at the testing center at Family Clinic listened to my lungs and said they sounded really bad and she prescribed a stronger steroid and sent me to the Hospital for a chest x-ray because she thought it was a false covid test or pneumonia. The chest x-ray came back clear with no pneumonia -August 18, 2021, I followed up with my primary care giver at Family Medicine, and I was told my lungs still sounded bad and they didn''t know why, therefore, they are referring me to a pulmonary specialist and I have an appointment there on 10/12/21. I still continue to cough and have congestion. I continue to use my nebulizer 2-3 times daily per doctor''s orders.


VAERS ID: 1628598 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-26
Onset:2021-08-09
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Bronchial secretion retention, Cardio-respiratory arrest, Endotracheal intubation complication, Respiratory failure, SARS-CoV-2 test
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypokalaemia (broad), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, Folic acid, HCTZ, Jardiance, Lisinopril, Lyrica, Metformin, ASA, Gabapentin
Current Illness: UNKNOWN
Preexisting Conditions: Obesity, HTN, non-insulin dependent DM.
Allergies: No Known Allergies
Diagnostic Lab Data: SARS COV2 COVID 19 PCR 08/09/2021
CDC Split Type:

Write-up: 08/09/2021 51-year-old male medical history significant for obesity hypertension non-insulin-dependent diabetes mellitus presenting with respiratory failure on 08/09. Patient failed high-flow cannula in the ED initially requiring intubation. Per records patient was a difficult airway. Approximately 5 minutes after being being received, patient suffered brief cardiopulmonary arrest secondary to mucus plug which was eventually dislodged. Patient is now on 100% FiO2 saturations of 95%. TRANSFER: Patient transferred to another facility secondary to bed availability issues. 51-year-old male medical history significant for obesity hypertension non-insulin-dependent diabetes mellitus presenting with respiratory failure on 08/09. Patient failed high-flow cannula in the ED initially requiring intubation. Per records patient was a difficult airway


VAERS ID: 1628614 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hypertension, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Hypertension (narrow), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer COVID-19 vaccine - Pt had a mild anaphylactic reaction about 40 minutes post administration
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Zpack, shellfish, Pfizer COVID-19 vaccine
Diagnostic Lab Data: Taken to ED and evaluated by ED staff.
CDC Split Type:

Write-up: Patient had adverse reaction several weekes ago to Pfizer vaccine. Per MD instructions, she was to get 2nd shot of J&J. Within 10 minutes patient reported mild lightheadedness. Given a bottle of water to drink and about 15 minutes post injection, patient reported blurry vision in her right eye. Discussed situation and Hx with other staff on site and it was decided the best course of action would be to take patient to ED for further evaluation. Patient was escorted by 2 RNs to the ED where SBAR was given to triage staff. at about 10:00am. Patient and her daughter returned about an hour later to thank us and let us know her symptoms had resolved and that her BP in the ED was "a little high".


VAERS ID: 1628629 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Arthralgia, Blood test, Feeling abnormal, Feeling jittery, Pain in extremity, Peripheral swelling, Speech disorder, Thrombosis, Tremor, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament 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:
Current Illness:
Preexisting Conditions:
Allergies: Bactrim
Diagnostic Lab Data: Ultrasound, blood work.
CDC Split Type: vsafe

Write-up: I felt really jittery right after the vaccine. I was trying to talk and it was like I couldn''t talk properly. I was having brain fog pretty bad. The brain fog thing was happening for awhile. It eventually went away. I felt sore in my joints and stuff like that. I went outside to do some yard work and I started shaking really bad. My husband brought me some water and the water couldn''t even stay in the cup because I was shaking so bad. I noticed that my arm started to swell pretty bad and it hurt tremendously. I went in and saw my PCP and he sent me to the ER to get an ultrasound done. They found blood clots in my arm. I was sent to a hematologist. I was put on Eliquis. 2 weeks later, I went back in and they did more blood work. I just went in recently and they did blood work again. They told me to finish the bottle that I''m on and they want to see me again 11/16. I believe that day they are going to do more blood work.


VAERS ID: 1628663 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-21
Onset:2021-08-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: tightness of chest and chest pain. some dizziness


VAERS ID: 1628701 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: Shortly after receiving the vaccine the patient fainted and bumped head on the floor.


VAERS ID: 1628724 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diplegia, Dysstasia, Gait inability, Hypoaesthesia, Laboratory test, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Sexual dysfunction (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, 35 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ammoninium lactate 12% lotion 225g - Celecoxib 200 Mg capsule - Emerita Pro-Gest progesterone cream 1 patch once per week - Esomeprazole Magnesium Dr 40 Mg - Estradiol 0.0375 MG DIS ALV patch - Gabapentin 300 MG capsule 3 capsules per day -
Current Illness: None
Preexisting Conditions: Diagnosed with Hashimoto''s Disease 07/2018 - Asthma since birth
Allergies: Tylenol with Codeine - Biaxin - Sulpha Drugs and cream - Statin Drugs - Lipitor/Provocol - Some shellfish - Tussionex Ext-el Sus cough syrup
Diagnostic Lab Data: A lot of test that began on Thursday, August 12 until present and beyond. I do not know the names or the tests or the dates. The hospital has a record of that.
CDC Split Type:

Write-up: On August 11, 2021, I noticed that my legs were becoming numb. By the next morning, I could not walk or stand up. I was paralyzed from my belly button to my tippy toes My legs and feet felt like pins and needles! I was in excruciating pain. I was rushed to Hospital where I am now presently in the Inpatient Rehabilitation Center.


VAERS ID: 1629284 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-07
Onset:2021-06-27
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Blood test, Computerised tomogram abdomen abnormal, Mesenteric vein thrombosis, Ultrasound biliary tract
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Marlissa, Alprazolam, Asprin(low dose), Metoprolol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 6-27-21 ultrasound on gallbladder with bloodwork. 6-29-21 abdominal CT scan with bloodwork. 7-30-21 follow up appointment with hospital surgeon. 8-4-21 hematology appointment with Dr. for bloodwork. 8-10-21 appointment with Dr. with Gastroenterology scheduled CT scan for 10-1-21. 8-11-21 Hematology appointment for follow up from 8-4-21 bloodwork, was given no other reason for abdominal blood clots other than Janssen vaccination.
CDC Split Type:

Write-up: Severe abdominal pain started on 6-27-21. Went to ER on 6-28-21 they did ultrasound on gallbladder & prescribed pain medication & was released. Went to ER on 6-29-21 with severe abdominal pain, they done a CT scan was admitted with diagnosis of Mesenteric Venous Thrombosis(blood clots in veins to intestines & liver). At Hospital was given Heparin, via intravenous until released on 7-4-21. Hospital released me on 7-4-21 with prescript of Eliquis with multiple follow-up doctors appointments


VAERS ID: 1629299 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206421A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Paraesthesia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot per patient interview
Other Medications: unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Flu shot, Penicillin. Tdap
Diagnostic Lab Data: BP: 80/63mmHg
CDC Split Type:

Write-up: Pt explained he had a history of poor reactions to vaccines historically (flu-like symptoms with Tdap and trigger if seizures with flu shot). Explained to pt potential risk may occur d/t poor history but decided to vaccinate d/t no previous history of covid vaccine. After administration. pt started to feel light headed and dizzy. Started to sweat, have hand tremors, and stated he felt intense tinglines all over hands. Took BP reading, was 80/63mmHg. Administered 0.3mg of Epi-pen into right-thigh hand called 911. Paramedics came and took patient to Emergency room.


VAERS ID: 1629860 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-19
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, Pain in extremity, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: On Aug 13 I had severe headache follow ed by nausea and heavy vomitinh I spent the afternoon in ER - got IV for the pain and vommitting On Aug 24 I had weird and strong pain and trembling in left leg


VAERS ID: 1630944 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain, Paraesthesia, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Gabapentin
Current Illness: Varicose veins High blood pressure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pin-like pains all over body Burning under skin all over body Small pains all over body


VAERS ID: 1631053 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Coagulation factor V level, Dental necrosis, Thrombosis, Toothache, Venous occlusion
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Osteonecrosis (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: Alcohol use (1 glass daily); Non-smoker.
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Name: Coagulation factor V level; Result Unstructured Data: Negative.
CDC Split Type: USJNJFOC20210838162

Write-up: TOOTH WAS NOW DEAD; PAIN ON UPPER MOLAR RIGHT SIDE; ONE VEIN WAS COMPLETELY BLOCKED AND THREE OTHER VEINS PARTIALLY BLOCKED; BLOOD CLOT; This spontaneous report received from a patient concerned a 60 year old white male of unknown ethnicity. The patient''s weight was 193 pounds, and height was 73 inches. The patient''s concurrent conditions included drinks alcohol, and was non smoker. 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: 042A21A, and expiry: 21-JUN-2021) dose was not reported, 1 total administered at left deltoid around 12:00 in noon on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the patient noticed red marking and pain on the right leg. On 05-AUG-2021, diminished the use of right leg and walk was affected. On 06-AUG-2021, patient went to emergency room and diagnosed with blood clot and one vein was completely blocked and three other veins partially blocked. As of 06-AUG-2021, the patient was started on Eliquis 20 mg per day for 7 days. On 11-AUG-2021, the patient begins to feel pain on upper molar right side, so patient went to dentist on 18-AUG-2021. The patient was informed that the tooth was now dead, may had been micro clot blocking of circulating. At the time of this report the patient was on Eliquis 10 mg daily and regimen will last for six months. On an unspecified date, patient underwent factor 5 genetic marker test which was negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tooth was now dead, and the outcome of blood clot in vein and one vein was completely blocked and three other veins partially blocked was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210838162- covid-19 vaccine ad26.cov2.s-blood clot, one vein was completely blocked and three other veins partially blocked, tooth was now dead. 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: 1631064 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling hot, Hypoaesthesia, Insomnia, Musculoskeletal stiffness, Myalgia, Neuralgia, Pain in extremity, Palpitations, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: IBUPROFEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210842990

Write-up: NERVE PAIN; INTENSE HEAT IN BACK AND BACK HOT TO TOUCH; COULD NOT SLEEP; COULD NOT BEND FINGERS ON SIDE RECEIVED INJECTION; HEART RACING IN HEAD AND EARS INTENSELY; ARM SWOLLEN; LEG PAIN ,SEVERE PAIN WHOLE ARM AND INTENSE PAIN FROM LEGS UP HER BACK; ARM WAS NUMB; UPPER ARM HARD TO THE TOUCH AND PAIN IN BICEPS AND TRICEPS; This spontaneous report received from a patient concerned a 35 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A,expiry: 21-SEP-2021) dose was not reported, administered on 28-JUL-2021 10:00 for prophylactic vaccination. Concomitant medications included ibuprofen for leg and back pain. On 28-JUL-2021, the patient experienced could not sleep. On 28-JUL-2021, the patient experienced could not bend fingers on side received injection. On 28-JUL-2021, the patient experienced heart racing in head and ears intensely. On 28-JUL-2021, the patient experienced arm swollen. On 28-JUL-2021, the patient experienced leg pain, severe pain whole arm and intense pain from legs up her back. On 28-JUL-2021, the patient experienced arm was numb. On 28-JUL-2021, the patient experienced upper arm hard to the touch and pain in biceps and triceps. On 29-JUL-2021, the patient experienced nerve pain. On 29-JUL-2021, the patient experienced intense heat in back and back hot to touch. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nerve pain, and intense heat in back and back hot to touch on 01-AUG-2021, could not sleep, and heart racing in head and ears intensely on 31-JUL-2021, could not bend fingers on side received injection on 02-AUG-2021, and arm swollen on 20-AUG-2021, was recovering from arm was numb, and the outcome of upper arm hard to the touch and pain in biceps and triceps and leg pain ,severe pain whole arm and intense pain from legs up her back was not reported. This report was non-serious.


VAERS ID: 1632394 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-17
Onset:2021-05-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac imaging procedure normal, Cardiac stress test normal, Chest discomfort, Chest pain, Echocardiogram normal
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topomax, Atorvastatin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Echogram. Nuclear imaging, Stress test. Normal results 7/9, 8/17
CDC Split Type:

Write-up: Chest pain after one week of injection from vaccine. Patient has had continuous chest pain since vaccine. Patient was admitted to emergency room on 7/9 for chest pain. Examination came back normal. Stress test was conducted 8/17. Stress test showed normal results. Doctors are unsure of what is causing chest discomfort. No shortness of breath. Just a constant pain in center of chest, sometimes migrating to left or right side. No history of acid reflux. Patient has a family history of heart disease. Patient is not overweight and lives an active, relatively healthy lifestyle.


VAERS ID: 1632397 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-19
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Electrocardiogram normal, Myalgia, Paraesthesia, Ultrasound scan normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Probotics, Omega 3
Current Illness: Inflamation of intestines
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None offered or given
CDC Split Type:

Write-up: Muscle pain in left arm, chest and left back at shoulder blade. Tingling in left arm. Started on 8/19/2021 and continues, as of 8/25/2021. Had ultrasound and EKG, both negative.


VAERS ID: 1632544 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Fatigue, Feeling abnormal, Gait inability, Inflammation, Inflammatory marker increased, Malaise, Nausea, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NP thryoid Testostorone cream Progrestone pills
Current Illness: I had torn my Achilles heel 1 month earlier, but was almost healed.
Preexisting Conditions: Lyme disease, Babesia, immune disfunction
Allergies: Gluten and Dairy
Diagnostic Lab Data: I had blood drawn a few weeks later and all my inflammatory markers were elevated.
CDC Split Type:

Write-up: I was super sick that night with 102 fever that lasted for three days. I called my doctor who said if I was not better in 5 days she would send me to the hospital. My whole body got inflamed and my feet blew up like balloons where I could not walk. I was weak, tired, nauseous and felt like I was dying for almost five days.


VAERS ID: 1632565 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Depersonalisation/derealisation disorder, Feeling abnormal, Flushing, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Patient disclosed that had a "bad" reaction to a flu vaccine in the past
Other Medications: Pt stated that has a PCP Doctor F. and stated that also sees rheumatologist . Pt stated that take Hydroxychloroquine. Patient stated "my rheumatologist wanted me to get the vaccine".
Current Illness: To the best of my knowledge, patient hasn''t disclosed any at the time of the vaccine.
Preexisting Conditions: Please contact patients PCP
Allergies: States that has had "bad reaction" to influenza immunizations in the past.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Reported feeling flushed, some swelling at the injection site, stated "I just don''t feel right" Patient was stable, was being monitored. BP checked 147 systolic. Pt reported feeling worse "I just don''t feel myself" Paramedics were called and transported patent from the hospital


VAERS ID: 1632594 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-08-20
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 + 8/21/21
CDC Split Type:

Write-up: Hospitalized with Covid-19 4 months after vaccine


VAERS ID: 1632711 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-12
Onset:2021-05-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Bradycardia, Echocardiogram, Electrocardiogram, Fear, Heart rate abnormal, Heart rate decreased, Hyperhidrosis, Hypertension, Pain, Palpitations, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levocitirizine Crestor Atenolol Hydrocodone
Current Illness: I had a spinal fusion five weeks prior but no illnesses all year.
Preexisting Conditions: Ehlers Danlos syndrome, osteoarthritis, fibromyalgia, and A variety of diagnoses about my spine such as degenerative disc disease, mild scoliosis, and other anomalies.
Allergies: Slight rash with penicillin as a child. Sensitive to NSAID?s and other antibiotics- they cause gastric upset. Lactose intolerant. Allergic to either crab or mussels- broke out in hives after eating them both at the same time. Allergic to HEAT. Countless environmental allergies. I have a lot of test results but in my effort to complete this process months ago numerous times I?ve run out the time allotted. Thus time I just NEED YOU TO KNOW what happened to me and if anyone can Give me any information that will help me decide whether or not to get a booster shot.
Diagnostic Lab Data: The hospital did the blood test and an echo cardiogram and an EKG and determined that I did not have a heart attack. That?s all they could tell me. My paperwork said that I was admitted for a potential life-threatening event. It was weeks before my heart rate returned to normal. My normal heart rate puts me in the bradycardia zone. My heart rate was sustained in the 90s for about 5 days, dropping into the 80s for about five days, and the same thing for the 70s and into the 60s. It wasn?t until six weeks later that I started running my normal heart rate.
CDC Split Type:

Write-up: Four hours after the shot I began to feel achy. I went to sleep. Two hours later I woke up sweating profusely. I woke up because I could hear my heart pounding in my ears very hard. I tried to fall asleep but it continued to get worse. I got up and took my blood pressure and it was very high, too high, and my heart rate was 122. I tried to relax for an hour; however, my heart rate never dropped below 102 and my blood pressure continue to be in the high range. by 11 PM I had called the emergency room and although they could not to offer me advice I? decided to go there. My heart felt like it was going to explode. Since I have Ehlers Danlos syndrome which is a connective tissue disorder and there is a concern about aortic aneurysms, and my mother had an aortic aneurysm and a stroke, I was terrified. I am only six years younger than she was at her time of death from a stroke that resulted after an aortic aneurysm.


VAERS ID: 1632866 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-30
Onset:2021-07-16
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Chest X-ray, Cough, Dyspnoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, Type 2 Diabetes
Allergies: E-mycin
Diagnostic Lab Data: CXR, covid test
CDC Split Type:

Write-up: Cough, SOB, left lower quadrant abdominal pain.


VAERS ID: 1632887 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-27
Onset:2021-07-16
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Dizziness, Fatigue, SARS-CoV-2 test
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), 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:
Current Illness:
Preexisting Conditions: Chicken pox
Allergies: NKA
Diagnostic Lab Data: Cxr, covid test
CDC Split Type:

Write-up: Dizziness, weakness, fatigue.


VAERS ID: 1632978 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK RA / UN

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Tinnitus, Vertigo, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Dizziness, light headed, intense spinning vertigo on May 4, 2021 about 25 days after injection. Ongoing vision and balance/vertigo issues. Ringing in both ears.


VAERS ID: 1633030 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-17
Onset:2021-07-07
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203H21H / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Cardiac stress test, Computerised tomogram head, Electrocardiogram, Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ct scan of brain on 07-08-2021, blood work several times, ekg done on 07-22-2021, and stress test done on 08-02-2021.
CDC Split Type:

Write-up: bells palsy, given prednisone, symptoms of that went away after a couple of weeks but I stared to develop tingling in both hands and feet and lips and tip of tongue. this is still present to this day. have had blood work stress test, ekg.


VAERS ID: 1633064 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-11
Onset:2021-05-27
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Dyspnoea, Thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin Atorvastain Fenofibrate Lisinopril B12
Current Illness: None
Preexisting Conditions: High blood pressure High cholesterol Type 2 diabetic
Allergies: N/a
Diagnostic Lab Data: 05/27/2021. 05/29/2021 CT scan at hospital 06/05/2021 _ 06/07/2021 ct scan at hospital
CDC Split Type:

Write-up: Shortness of breathe blood clots


VAERS ID: 1633121 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (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: Patient states he has had a similar reaction to influenza vaccine before
Other Medications: Albuterol Sulfate 8.5gm Proair HFA
Current Illness: ETOH
Preexisting Conditions:
Allergies: azithromycin (Verified Allergy, Mild, rash, 8/24/21) cefixime (Verified Allergy, Mild, rash, 8/24/21) Amoxicillin (Verified Allergy, Unknown, UNK, 8/24/21) PCN (penicillin) (Verified Allergy, Unknown, UNK, 8/24/21) Promethazine (Verified Allergy, Unknown, UNK, 8/24/21) erythromycin base (Verified Allergy, Unknown, Unknown, 8/24/21) mold (Verified Allergy, Unknown, Unknown, 8/24/21) prochlorperazine (Verified Allergy, Unknown, Unknown, 8/24/21) ragweed pollen (Verified Allergy, Unknown, Unknown, 8/24/21) C-CHLOR (Allergy, Mild, rash, 4/30/15) fluroquinolones (Allergy, Unknown, Unknown, 1/26/18)
Diagnostic Lab Data:
CDC Split Type:

Write-up: lightheadedness and dizziness, hypotensive at BP 80/63, diaphoretic


VAERS ID: 1633359 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: Patient got dizzy and passed out about 5 minutes after the shot


VAERS ID: 1633599 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-14
Onset:2021-07-31
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Seasonique Amitriptyline Omeprazole Magnesium B12
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Venous ultrasound
CDC Split Type:

Write-up: On August 6 I was diagnosed with a DVT to my right leg. The clot went from my calf to my mid thigh.


VAERS ID: 1633772 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-07
Onset:2021-07-28
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Body temperature increased, COVID-19, Chest X-ray normal, Dyspnoea, Fatigue, Feeling hot, Fibrin D dimer normal, Headache, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily Multicap Vitamin D3 with K1 & K2 Vitamin B-12 Broad Spectrum Magnesium Caps De3 Dry Eye Omega Benefits with Vitamin D3 Sudafed
Current Illness: Seasonal allergies
Preexisting Conditions: Seasonal allergies Lactose Intolerant to the extreme (developed from previous surgery: injectable antibiotics took away my ability to process lactose)
Allergies: Allergic to cephalosporins and sulfa drugs
Diagnostic Lab Data: Chest x-ray, 8/9/2021 D-dimer test, 8/9/2021
CDC Split Type:

Write-up: Contracted COVID-19 through work place (co-worker) on Wednesday 07/21/2021; we were in same office, neither had a mask on and she was coughing an extraordinary amount. She had already been out of the office Monday and Tuesday of that same week and was feeling ill on the previous Friday. She was told the night before at urgent care it was a sinus and ear infection, but they did not test her for COVID-19. I became ill on Wednesday night, 07/28/2021 with slight headache and general not feeling well around 8:30pm. Took some Tylenol and Ibuprofen, went to bed. Thursday, 07/29/2021, woke up still feeling not quite right, took Tylenol and Ibuprofen again and went to work early at 6:30am to cover since my co-work was out ill. By 7:30am on Thursday morning I felt super warm in my office that only had a temperature of 73 degrees. I gathered my work stuff, sprayed Lysol all over my office and left to go home. Took my temperature when I arrived home and it was 100.8. I let my employer know I had a fever, would schedule a COVID test and work from home for the day. COVID-19 test was done at 9:30am. Positive test results were received around 5:00pm that evening. On Friday, 7/30/21 I lost all sense of taste and smell. During the course of the next 11 days, I was home with severe pounding headache anytime I moved from sitting to standing, standing to sitting, walking, bending over and laying flat. Fatigue set in on day 4 of being home. I isolated as much as I could from my 2 other family members and wore a 3 layered face mask all day long except for eating and drinking. At day 9, I called my insurance Doc who prescribed for me: Benzonatate 100 MG CAP EPIC, Flovent HFA 220 MCG/ACT AER GLAX and Albuterol 108 MCG/ATC AER LUP. I started the Benzonatate and Flovent that night on 08/05/2021. At day 11-12 I became super short of breath and went back to urgent care (PCP would not see me). Urgent care recommended I get re-tested anytime after day 15 and sent me to the ER for a chest x-ray to rule out pneumonia and for a D-dimer test to rule out any blot clot issues. The chest x-ray showed my lungs were good and the D-dimer test showed no signs of any blot clotting occurrences. I returned to work on Friday 08/13/2021 but not at 100% better and still not return of taste & smell. I continued the Flovent inhaler through Friday 08/20/21 which when taken helped my sense of taste and smell to return slightly. I am still to date, 08/25/2021, experiencing major fatigue, long lingering and painful headaches that build throughout the day and my sense of smell and taste is faint every morning and slowly returns through each day. I am hoping soon to be rid of all these lingering effects of having this virus.


VAERS ID: 1634195 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-27
Onset:2021-07-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Blood test, Chest pain, Clumsiness, Computerised tomogram, Dizziness, Drooling, Electrocardiogram, Feeding disorder, Feeling abnormal, Headache, Hypoaesthesia, Immediate post-injection reaction, Nausea, Pain in extremity, Presyncope, Vertigo, Weight decreased
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Tetanus age 52 02/21 neuropathy, pneumonia vaccine couldn?t breathe , rash , heart racing in 2015, 1973 Bell?s palsy as a child
Other Medications: Multivitamin, levothyroxine , klonopin
Current Illness: PTSD since 1989 , mild low thyroid
Preexisting Conditions: Osteoarthritis, anxiety
Allergies: Antibiotics, PEG, red dye , sulfa medicine, neomycin, antidepressants, herbal tea, nuts and seeds , shellfish, wheat gluten,
Diagnostic Lab Data: Blood tests , cat scan , ekg, 7/28/21 7/31/21 8/2/21 8/15/21
CDC Split Type:

Write-up: Arm pain and numbness, chest pain , heart pain was immediately after the shot Face numbness, legs numb , arms numb, left side of body goes numb then right side intermittently, massive headache next day , spinning extreme vertigo , extreme nausea almost passed out , 12 lb weight loss , can?t eat all this in the first 6 days. Still now have face numbness, arms , legs , hands , feet , brain fog . Drooling with face numbness that comes and goes. Dizziness and clumsy.


VAERS ID: 1634219 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-09
Onset:2021-05-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Magnetic resonance imaging, Migraine, Muscle spasms, Neurological symptom
SMQs:, Dystonia (broad)

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

Write-up: Partial stroke like effects. Complex migraines, muscle spasms


VAERS ID: 1634845 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood pressure measurement, Body temperature, Haemoglobin, Heart rate, Ophthalmic herpes zoster, Physical examination, Platelet count, Respiratory rate, Visual acuity tests, White blood cell count
SMQs:, Guillain-Barre syndrome (broad), Ocular infections (narrow), Opportunistic infections (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:
Current Illness: Asthma
Preexisting Conditions: Medical History/Concurrent Conditions: Chickenpox (Admitted to the history of chickenpox at the age of 10.); Comments: The patient denied any sick contacts, recent emotional or physical stress, recent travel, or steroid usage in the past one year.
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: 151/89; Test Name: Respiratory rate; Result Unstructured Data: 18; Test Name: Heart rate; Result Unstructured Data: 93; Test Name: Physical examination; Result Unstructured Data: Erythematous grouped vesicles on the left side of the face; Test Name: Visual acuity tests; Result Unstructured Data: limited; Test Name: Hemoglobin; Result Unstructured Data: 15 g/dL; Test Name: Platelet count; Result Unstructured Data: 274000 cells/microL; Test Name: Body temperature; Result Unstructured Data: Afebrile; Test Name: White blood cells; Result Unstructured Data: 5.50 cells/microL
CDC Split Type: USJNJFOC20210832958

Write-up: IPSILATERAL HERPES ZOSTER OPTHALMICUS; GENERALIZED WEAKNESS; This spontaneous report was received from literature: . This report concerned a 42 year old male of an unspecified race and ethnicity. The objective of this study was to describe Ipsilateral HZO (Herpes Zoster Ophthalmicus), an opthalmological emergency of herpes zoster (HZ) seen post Covid-19 vaccination in healthy young adults. The patient''s height, and weight were not reported. The patient''s past medical history included: admitted chickenpox at the age of 10, and concurrent conditions included: asthma. The patient denied any sick contacts, recent emotional or physical stress, recent travel, or steroid usage in the past one year. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown and expiry: unknown) dose, start therapy date were not reported, frequency time 1 total administered at left arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, post COVID-19 vaccination the patient experienced generalized weakness for two days. One week after receiving the vaccination, the patient noticed that skin lesions started appearing as small pimples on the left side of his forehead that were associated with burning pain and itching. The lesions had then rapidly progressed to the left side of the scalp, the tip of the nose, and the left upper eyelid. Associated symptoms were watery discharge from the eyes and blurred vision. He denied having any other complaints. On an unspecified date, the patient presented to the emergency room with the above mentioned complaints. Laboratory data included: blood pressure which was found to be 151/89, body temperature was found to be afebrile, heart rate was found to be 93, hemoglobin (NR: 13.5 - 17.5) was found to be 15 g/dL. Physical examination revealed erythematous grouped vesicles on the left side of the patient''s forehead, left upper eyelid, left side of the scalp and tip of his nose. The left eyelid appeared to be edematous with conjunctival injection and watery discharge, with no visible corneal endothelial decompensation. There was restricted ocular movement noticed due to edema of his upper eyelid. Visual acuity test was also found to be limited. Platelet count (NR: 150000 - 450000) was found to be 274000 cells/microL, Respiratory rate was 18, and White blood cells (NR: 4500 - 11000) were 5.50 cells/microL. Based on clinical examination findings, the diagnosis of ipsilateral HZO (Herpes Zoster Ophthalmicus) was made. He was started on systemic antiviral (antivirals for systemic use) and antiviral eye drops, which halted the progression of vesicles and improved his vision. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from generalized weakness, and the outcome of ipsilateral herpes zoster opthalmicus was not reported. The authors emphasized on the awareness that must be created among physicians, as well as the general public by reporting any associations with the COVID-19 vaccine and HZ (Herpes zoster) to CDC (Centers for Disease Control and Prevention). It was recommended that immunocompromised individuals greater than 50 years of age be vaccinated against HZ (Herpes zoster). Early recognition and antiviral usage can halt the progression of the disease and thus prevent debilitating complications. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210832958-Covid-19 vaccine ad26.cov2.s-ipsilateral herpes zoster ophthalmicus. 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: 1634850 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-07-30
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abnormal faeces, Antiphospholipid antibodies, Blood pressure increased, Blood pressure measurement, Body temperature, Chills, Computerised tomogram, Decreased appetite, Deep vein thrombosis, Fatigue, Haemorrhage, Headache, Intestinal ischaemia, Lethargy, Magnetic resonance imaging, Malaise, Mesenteric vein thrombosis, Platelet count, Platelet count decreased, Portal vein thrombosis, Post thrombotic syndrome, Pulmonary embolism, Pyrexia, SARS-CoV-2 test, Splenic vein thrombosis, Ultrasound scan, Vomiting, Weight decreased, X-ray
SMQs:, Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (narrow), Hypertension (narrow), Noninfectious diarrhoea (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypertension
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210730; Test Name: Body temperature; Result Unstructured Data: 99.2 F; Test Date: 20210730; Test Name: Blood pressure; Result Unstructured Data: 170/110 mmHg; Test Date: 20210731; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 202108; Test Name: Antiphospholipid antibodies; Result Unstructured Data: Positive; Test Date: 20210803; Test Name: Platelet count; Result Unstructured Data: 37,000; Test Date: 20210813; Test Name: Nuclear magnetic resonance imaging; Result Unstructured Data: The bowel lining was compromised by the blood clot and was sloughing.; Test Date: 20210816; Test Name: CT scan; Result Unstructured Data: Various locations of clots as per report; Comments: major clots in portal vein.; Test Date: 20210819; Test Name: Platelet count; Result Unstructured Data: 230,000; Test Name: X-ray; Result Unstructured Data: unspecified; Test Name: Diagnostic ultrasound; Result Unstructured Data: not reported.
CDC Split Type: USJNJFOC20210840439

Write-up: BILATERAL CLOTS IN THE LEFT AND PROXIMAL MAIN PORTAL VEIN/ MULTIPLE BILATERAL CLOTS IN THE LUNGS; CLOTS IN SPLENIC VEIN; BOWEL LINING COMPROMISED BY THE BLOOD CLOT; BLEEDING (SLOUGHING OFF); MULTIPLE DVTS RIGHT LEG; MULTIPLE BILATERAL CLOTS IN LUNGS/ BILATERAL PULMONARY EMBOLISM; SMALL CLOTS WITHIN THE SMV (SUPERIOR MESENTERIC VEIN); ABDOMINAL MESENTERIC ISCHEMIA; PLATELET COUNT DECREASED 37 000; POST THROMBOTIC SYNDROME; BLOOD PRESSURE INCREASED; WEIGHT LOSS (15 LBS); CHILLS/ SHAKING; VOMITING/THREW UP; LETHARGIC; FELT SICK; FEVER OF 99.2; SEVERE HEADACHE; EXTREMELY TIRED; APPETITE IMPAIRED (NEVER ATE, COULD NOT KEEP ANYTHING DOWN); This spontaneous report received from a consumer concerned a 54 year old, not Hispanic or Latino, white male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension. The patient was previously treated with lisinopril for hypertension. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: unknown) dose was not reported, 1 total administered on 23-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-JUL-2021 around 05:30 a:m, the patient experienced severe shaking/chills, felt terrible and sick, vomiting/threw up, lower back pain, fever of 99.2 F, blood pressure increased, lethargic, severe headache, appetite impaired (never ate, could not keep anything down), extremely tired, felt sick. Laboratory data included: Blood pressure (NR: not provided) 170/110 mmHg. On 31-JUL-2021, the patient felt horrible and saw a teledoc. Teledoc said to get the antibodies done, Laboratory data included: COVID-19 virus test (NR: not provided) Negative, Antiphospholipid antibodies (NR: not provided) Positive. On 03-AUG-2021, the patient experienced platelet count decreased 37000 unspecified units. On AUG-2021, the patient experienced post thrombotic syndrome. On 09-AUG-2021, the patient experienced abdominal mesenteric ischemia, multiple bilateral clots in lungs/ bilateral pulmonary embolism, small clots within the SMV (superior mesenteric vein), thrombosis pulmonary, severe abdominal pain and for that visited emergency department, flank pain, dry heaves in ICU (Intensive Care Units). The patient was hospitalized. On 10-AUG-2021, the patient experienced multiple deep vein thrombosis right leg and bleeding (sloughing off). On 13-AUG-2021, the patient experienced bowel lining compromised by the blood clot. Would take 2-3 weeks to heal. Laboratory data included: Nuclear magnetic resonance imaging (NR: not provided) The bowel lining was compromised by the blood clot and was sloughing. On 16-AUG-2021, Laboratory data included: Computed tomography (CT) scan (NR: not provided) Various locations of clots as per report. His clots were still there but some had improved. On 17-AUG-2021, the patient experienced bilateral clots in the left and proximal main portal vein/ multiple bilateral clots in the lungs and clots in splenic vein. On 19-AUG-2021, the patient experienced weight loss (15 lbs.). Laboratory data included: Platelet count (NR: not provided) 230, 000 unspecified units. Laboratory data (dates unspecified) included: Diagnostic ultrasound (NR: not provided) not reported, and X-ray (NR: not provided) unspecified. Other diagnostic data included PT and PTT. On 20-AUG-2021, the patient was still hospitalized. Blood pressure was still not under control and had fluctuated in hospital due to pain. At the time of report patient was on blood thinners which his wife indicated he would likely be on for the rest of his life. He was being followed by hematology. The action taken with covid-19 vaccine ad26.cov2.s was not reported. The patient recovered from dry heaves in ICU, and chills/ shaking, and fever of 99.2 on 30-JUL-2021, was recovering from vomiting/threw up, feels terrible/felt horrible, lethargic, severe headache, flank pain, extremely tired, bowel lining compromised by the blood clot, small clots within the SMV (superior mesenteric vein), bilateral clots in the left and proximal main portal vein/ multiple bilateral clots in the lungs, clots in splenic vein, multiple bilateral clots in lungs/ bilateral pulmonary embolism, severe abdominal pain, low back pain, blood pressure increased, and platelet count decreased 37000, had not recovered from appetite impaired (never ate, could not keep anything down), multiple DVTS right leg, and felt sick, and the outcome of weight loss (15 lbs.), bleeding (sloughing off), post thrombotic syndrome and abdominal mesenteric ischemia was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: This spontaneous report received from a consumer concerned a 54-year-old white man who experienced thrombocytopenia (day 11) and multiple sites of thrombosis in pulmonary, intra-abdominal, and peripheral sites (day 17) after vaccine. Medical history included hypertension treated with lisinopril. On day 7, the patient experienced severe shaking/chills, felt terrible and sick, vomiting, lower back pain, blood pressure increased, lethargic, severe headache, appetite, extremely tired. On day 8: COVID-19 virus test Negative, Antiphospholipid antibodies Positive. On day 11, platelets were 37,000. On day 17, the patient experienced abdominal mesenteric ischemia, multiple bilateral pulmonary emboli, small clots within the SMV (superior mesenteric vein), thrombosis pulmonary, severe abdominal pain and was admitted to intensive care. On day 18, the patient experienced multiple deep vein thrombosis right leg and bleeding. On day 21, the patient experienced bowel lining compromised by the blood clot with sloughing. On day 22, CT scan confirmed many clots. On day 23, the patient experienced bilateral clots in the left and proximal main portal vein/ multiple bilateral clots in the lungs and clots in splenic vein. On day 24, the patient experienced weight loss (15 lbs.). Laboratory data included: Platelet count improved to 230,000. On day 25, the patient was still hospitalized. Blood pressure was still not under control and had fluctuated in hospital due to pain. At the time of report patient was on blood thinners which his wife indicated he would likely be on for the rest of his life and he was being followed by hematology. Based on evolving knowledge of Thrombosis with Thrombocytopenia Syndrome (TTS, per definition from-BC), the low platelet count and temporal relationship to vaccination, the events are assessed to have a plausible relationship with vaccination. Additional information is requested.


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