National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 4/30/2021 release of VAERS data:

Found 153,440 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 75 out of 1,535

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174   next


VAERS ID: 1205964 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Adverse event, Asthenia, Blood test, C-reactive protein, Differential white blood cell count, Dizziness, Dyspnoea, Fatigue, Full blood count, Loss of consciousness, Metabolic function test, Muscle spasms, Pain in extremity, Pallor, Platelet count, Red blood cell sedimentation rate
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), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sulfa drugs
Diagnostic Lab Data: Bloodwork - CBC with differential/platelet, metabolic panel, c-reactive, and sedimentation labs (all labs drawn on 4/9)
CDC Split Type:

Write-up: Received vaccine at 3pm on 4/8 and adverse event happened the morning of 4/9. Leg cramps/pains, dizziness, shortness of breath, weakness, and fatigue. I passed out in the morning at a doctors appointment and took a couple minutes to get back consciousness. All color was drained from my face for hours and had to receive 2 bags of fluid. Still getting dizzy/light headed 5 days out from the vaccine.


VAERS ID: 1205993 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever and chills for 24 hours, hives for about 12 hours, body aches for 8 hours until Tylenol was taken. Fatigue and mental fogginess for 36 hours.


VAERS ID: 1205996 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site swelling, Injection site warmth, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Nearly a week after injection, injection site is still visibly swollen, slightly warm to touch. Blood clot passed vaginally (outside of normal menstruation schedule).


VAERS ID: 1206018 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-11
Onset:2021-04-09
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: PNC
Diagnostic Lab Data: Contact Hospital
CDC Split Type:

Write-up: I had a blood clot in my left lung. went to ER , spent three days in the hospital was given medications (Xarelto ) required to taking medication now for a least a year.


VAERS ID: 1206041 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was in attendance at the JANSSEN vaccination clinic on 4/9/21. After vaccination while he was in the observation area, PT experienced a syncopal episode and hit his head on the window sill next to where he was sitting. Staff responded and assessed PT and decided to initiate a MET call. There was concern that the patient may have experienced a seizure. Patient was taken to the Emergency Department. Patient was ultimately admitted on 4/9/21 with new onset of a. fib. He was discharged on 4/11/21. While hospitalized, the patient received IV cardizem


VAERS ID: 1206075 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Hypoaesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Swelling and numbness in legs (Burning sensation on top of


VAERS ID: 1206117 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Feeling abnormal, Headache, Neck pain, Pain
SMQs:, Retroperitoneal fibrosis (broad), Dementia (broad), Arthritis (broad)

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

Write-up: Weird, bad feeling at first followed by bad aching , joint pain, headache, shoulder pain, neck pain , back pain.


VAERS ID: 1206197 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

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

Write-up: I started to feel chilled around 7pm friday evening. I laid down and began to feel nauseous and hot; my skin was sensitive. I soon had a 103.7 fever with chills and a terrible splitting headache. My symptoms lasted through the night. I took one 200mg Ibuprofen at 03:30 saturday morning/it didn''t seem to help much. Most of the day saturday I had a headache that was manageable and 100.2 degree fever. Saturday evening I was fever free and had a dull headache. Sunday, I was exhausted.


VAERS ID: 1206232 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity, Ultrasound scan normal
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Leg pain in left calf for a number of days starting almost a week after getting vaccinated. I thought it might be a blood clot (this was e any news of blood clots was known). I had an ultrasound and it showed nothing. But I thought I?d report it anyway.


VAERS ID: 1206236 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: -
Current Illness: -
Preexisting Conditions: -
Allergies: -
Diagnostic Lab Data: high white blood cell count, CT scan (both on 4/9)
CDC Split Type:

Write-up: uncomplicated appendicitis, removed via surgery


VAERS ID: 1206267 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lyrica, Montelukast, Amphetamine XR 20 mg, Loratadine, Duloxetine
Current Illness: None
Preexisting Conditions: Fibromyalgia, Raynaud?s Phenomenon, ADD, Allergies(Indoor/Outdoor/Food), Depression, Generalized Anxiety Disorder
Allergies: Indoor/Outdoor allergens, bananas, watermelon, kiwi, peanuts, cashews, almonds.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Beginning at approximately 9:30 pm ET Friday, April 9, 2021, I began to experience extreme fatigue, fever, chills, extreme muscle/body aches and headache. I experienced soreness in my left arm. The symptoms lasted until the morning of Sunday, April 11, 2021.


VAERS ID: 1206381 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 15 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Crying, Disorientation, Dyspnoea, Hallucination, Inappropriate affect, Laboratory test, Muscle contractions involuntary, Musculoskeletal chest pain, Nausea, Pain, Pain in extremity, Pyrexia, Sensitive skin
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: On April 10th my vitals were taken at the hospital. Laboratory testing was done to check if I had consumed or was under any type of drug.
CDC Split Type:

Write-up: I received the Johnson and Johson Vaccine on April 9th between 10:00 a.m.-10:20 a.m., at 10:30 p.m. that same day my legs and feet started to ache (pain level 3), by 11:00 p.m. my feet and leg (pain level rose to a 6), I drank two 500 ml pain-relieving pills. By 11:30 p.m. (pain level rose to a 9), at that time my pain traveled up to my rib cage, I felt nauseous, felt chills, felt contractions on my stomach and lower back, I felt pain and sensitivity on my skin and caught a fever. Between 12:00 a.m.-2:00 a.m. my (pain level rose to 12), I had a high fever, felt weak, disoriented, lost track of time, started to hallucinate, could not breathe normally, and experienced involuntary and uncontrollable laughter and crying. 911 was called.


VAERS ID: 1206580 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210417610

Write-up: HEADACHE; PAIN IN ARM; This spontaneous report received from a parent concerned an 18 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. The batch no was not reported ,The company is unable to performed follow up to request batch /Lot numbers No concomitant medications were reported. On 09-APR-2021, the subject experienced headache. On 09-APR-2021, the subject experienced pain in arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, and pain in arm. This report was non-serious.


VAERS ID: 1206635 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Pain assessment, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (Once every weekend.); Arthritis viral; Non-smoker
Preexisting Conditions: Comments: Patient had no known allergies, no drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210409; Test Name: Pain scale; Result Unstructured Data: 4/10
CDC Split Type: USJNJFOC20210419863

Write-up: WARM TO TOUCH; SORENESS ON THE LEFT ARM (INJECTION SITE)/SORE; This spontaneous report received from a patient concerned a 22 year old male. The patient''s weight was 125 kilograms, and height was 170 centimeters. The patient''s concurrent conditions included alcoholic, non-smoker, and herpes, and other pre-existing medical conditions included patient had no known allergies, no drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced warm to touch. On 09-APR-2021, the subject experienced soreness on the left arm (injection site). Laboratory data included: Pain scale (NR: not provided) 4/10 (units unspecified). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from soreness on the left arm (injection site), and the outcome of warm to touch was not reported. This report was non-serious.


VAERS ID: 1206849 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Product administration error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210419942

Write-up: ALREADY VACCINATED TWO TIMES AND RECEIVED JANSSEN COVID19 VACCINE ACCIDENTALLY; This spontaneous report received from a pharmacist concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: not reported) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced already vaccinated two times and received Janssen covid19 vaccine accidentally. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of already vaccinated two times and received Janssen covid19 vaccine accidentally was not reported. This report was non-serious.


VAERS ID: 1206870 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Hangover
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420107

Write-up: CHILLS; HANGOVER; This spontaneous report received from a consumer concerned a 23 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included unknown. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, and expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced hangover. On 09-APR-2021, the subject experienced chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chills and hangover was not reported. This report was non-serious.


VAERS ID: 1206871 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420108

Write-up: CHILLS; FEVER; This spontaneous report received from a patient via a company representative concerned a 39 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced chills. On 09-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and chills. This report was non-serious.


VAERS ID: 1206873 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Headache, Pain in extremity, Polymerase chain reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient has not had any vaccines in a very long time.
Allergies:
Diagnostic Lab Data: Test Date: 20200830; Test Name: PCR; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210420136

Write-up: FEELING DIZZY AND WOOZY BY THE DAY; CHILLS; SORE ARM; BODILY WEAKNESS; BAD HEADACHE ON SOME PARTS OF HEAD; FEVER; This spontaneous report received from a consumer concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient has not had any vaccines in a very long time. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 30-AUG-2020, Laboratory data included: PCR (NR: not provided) Negative. On 09-APR-2021, the subject experienced feeling dizzy and woozy by the day. On 09-APR-2021, the subject experienced chills. On 09-APR-2021, the subject experienced sore arm. On 09-APR-2021, the subject experienced bodily weakness. On 09-APR-2021, the subject experienced bad headache on some parts of head. On 09-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, chills, bad headache on some parts of head, bodily weakness, sore arm, and feeling dizzy and woozy by the day. This report was non-serious.


VAERS ID: 1206876 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain
SMQs:, Retroperitoneal fibrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sciatica (had sciatica 5-10 years before.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420254

Write-up: SEVERE BACK PAIN ON LOWER LEFT SIDE AND WAS UNABLE TO MOVE OR SIT WITHOUT EXPERIENCING IT; This spontaneous report received from a patient concerned a 72 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included sciatica. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced severe back pain on lower left side and was unable to move or sit without experiencing it. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe back pain on lower left side and was unable to move or sit without experiencing it. This report was non-serious.


VAERS ID: 1206938 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

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

Write-up: I developed a moderate headache 3-4 hours after receiving the vaccine that became more painful over time. At 8 PM, I developed a rash on the left side of my face, neck and chest that lasted through the night and into the morning (about 12 hours). The rash did not look like hives, but it was itchy and blotchy red patches. I also spiked a 101 degree fever that lasted until the morning (about 12 hours).


VAERS ID: 1206955 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Head injury, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Janssen COVID-19 Vaccine EUA The morning after getting the vaccine I woke up feeling very tired and sore/achey all over. I got to work (I lifeguard at the pool on campus) at around 6:15am and helped get the pool set up. When I sat down to try to do homework I started feeling very dizzy and nauseous. The pool deck is very hot, so I decided to try to go into the pool office where it would be cooler. I remember walking through the door and into the office, and then laying down next to the trash can because I thought I might be sick. One of my coworkers brought me some water and Goldfish, and I layed on the office floor for the rest of my 45 minute shift. Afterwards, when I was looking for my laptop, my other coworker said that when I had tried to go through the door into the pool office I had run into the door (I later got a small lump on my head from this) and that I had dropped my latptop. I do not remember either of these happening, so I believe that I blacked out for a moment, and it was likely hitting my head on the door that woke me up. A small scratch and some mild pain in my foot leads me to believe I dropped the laptop partially, but not completely, on my foot. I felt very tired for the rest of the day, and a little dizzy up until about mid-afternoon. I spent most of the day in bed sleeping. Waking up the next morning I felt completely fine, and was able to go about all of my normal activities with no side effects at all.


VAERS ID: 1207035 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

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

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

Write-up: Janssen COVID-19 Vaccine EUA chill, fever, headache, nausea over 24 hour period followed by exhaustion for the next 24 hours


VAERS ID: 1207073 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Pain, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Body aches, fever, chills, headache, and heart palpitations that started approximately 12 hours administration of vaccine. Fever, chills and body aches subsided within 36 hours. Heart palpitations reduced but continue to occur periodically


VAERS ID: 1207092 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-03-01
Onset:2021-04-09
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Headache, Migraine, Photophobia
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)

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

Write-up: Onset of dull headache which worsened. Continued worsening into a massive migraine(cluster, light sensitive). After several hours I took a migraine relief OTC medication. The headache subsided with minor headache into the following day.


VAERS ID: 1207129 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-20
Onset:2021-04-09
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050258 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram, Magnetic resonance imaging, Urine analysis
SMQs:, Hearing impairment (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: CAT SCAN, MRI, BLOOD WORK, URINE SAMPLE, PHYSICAL ASSESSMENT ALL CONDUCTED ON 4/10/2021 AND 4/11/2021.
CDC Split Type:

Write-up: DEVELOPED BELLS PALSY AND WAS IN ER AND ADMITTED TO HOSPITAL ON 4/10/2021. DIAGNOSIS WAS BELLS PALSY BY A NEUROLOGIST ON STAFF


VAERS ID: 1207200 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Chest pain, Diarrhoea, Echocardiogram, Electrocardiogram, Heart rate increased, Hypertension, Injection site pain, Injection site pruritus, Palpitations, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol Clonazepam Escitalopram Bupropion Famotidine Pantoprazole Cetirizine Pyridostigmine Pramipexole Clonidine
Current Illness: Ehlers-Danlos Syndrome, Postural orthostatic tachycardia syndrome, Mast cell activation syndrome
Preexisting Conditions: Ehlers-Danlos Syndrome, Postural orthostatic tachycardia syndrome, Mast cell activation syndrome, Asthma
Allergies: N/A
Diagnostic Lab Data: Labs of blood, ECHO, X-ray, EKG, Checked for PE.
CDC Split Type:

Write-up: High heart rate (140-150) while sitting. High Blood Pressure (150/90) while sitting. Left side chest pain. Heart palpitations. Welt at injection site, was painful and itchy. Stomach cramping and loose stool.


VAERS ID: 1207212 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Computerised tomogram abdomen, Laboratory test
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propafenone, Lisinopril, Chlorthalidone, Liptor, Nexium, Vit D, Vit B12, CoQ10, Fiber, Zytec
Current Illness: none
Preexisting Conditions: Blood Pressure, Cholesterol, SVT''s
Allergies: none
Diagnostic Lab Data: blood work, cat scan on stomach, scan gall bladder on 4-11-2021
CDC Split Type:

Write-up: Sever Stomach pain, went to ER, they gave pain meds, check gall bladder, Cat scan on stomach, blood work


VAERS ID: 1207240 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fascial rupture, Headache, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexplanon Birth Control, Naproxen (taken 1 hour before the vaccination)
Current Illness: Torn fascia in right foot
Preexisting Conditions: N/A
Allergies: clindamycin, dilaudid, latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The morning after the injection I woke up with a slight fever (99.0 degrees), body aches, and a headache. The fever lasted for about 4-6 hours and the body aches and headache lasted until mid-day the following day.


VAERS ID: 1207250 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Dehydration, Dyspnoea, Fatigue, Neck pain, Night sweats, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None. I called my doctors office and they didn?t seem to care Told me to call FEMA where I got the vaccine but there is no number for that so I did this form
CDC Split Type:

Write-up: shortness of breath No energy Fever 103 for two days, Tylenol didn?t work to break it Full body sweats. I had to change my bed sheets 3 times in four days Body aches Sore in legs, neck and inside of my arms Dehydration The inside of my left arm still hurts and throbs (not where I got the shot)


VAERS ID: 1207261 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Cold sweat, Confusional state
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3 5000IU, Vitamin B12 1,000mcg, Vitaman C 1000mg, Vitamin Zinc 50mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Didn''t seek medical attention.
CDC Split Type:

Write-up: Friday, approximately 5:00 pm, my wife and I were leaving home to drive to grandson''s baseball game. Out of the house and on the driveway I became confused, couldn''t speak, felt "clammy" and began to perspire, and couldn''t drive. My wife was asking me questions and I couldn''t answer wedding date, her DOB, etc. The symptoms disappeared after 10-15 minutes but I felt almost the same as the minimal symptoms I had with my Covid positive, January 14. (My Covid experience resembled having a Cold).


VAERS ID: 1207284 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray abnormal, Chest discomfort, Fibrin D dimer increased, Nausea, Pleural effusion, Vomiting, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), 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), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NONE
Preexisting Conditions: ASTHMA
Allergies: SULFA, CEPHALOSPORIN, KEFLEX, LATEX, NSAIDS, TOPAMAX
Diagnostic Lab Data: 4/13/21: D-DIMER 1760. WBC 13.8 CHEST X-RAY: SMALL RIGHT PLEURAL EFFUSION
CDC Split Type:

Write-up: PT VOICED SHE TOOK PFIZER VACCINE THIS PAST FRIDAY (4/9/21). LATER THAT EVENING SHE BEGAN HAVING COVID-LIKE SYMPTOMS AND RIGHT SIDE CHEST PRESSURE (ON/OFF). ON 4/12/21 SHE BEGAN HAVING NAUSEA AND VOMITING AND COULDN''T KEEP ANYTHING DOWN SO SHE DECIDED TO CALL HER PCP. SHE WAS ADMITTED TO THE HOSPTIAL ON 4/13/21. PT VOICED SHE DIDN''T HAVE ANY PROBLEMS OR SYMPTOMS BEFORE SHE RECEIVED THE VACCINE.


VAERS ID: 1207341 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast or Singular for pollen allergies
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: No tests taken to date, wanted to see if the effects wore off after giving it some time in my system. I have called my doctors office and left a message to advise me how to proceed, if anything is even necessary.
CDC Split Type:

Write-up: Felt dizzy up to 10 minutes after the shot; then was okay drove home. Later that day got headache which is unusual, as I never get headaches and feeling tired to the present time. Wed 4/114/2021.


VAERS ID: 1207364 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Communication disorder, Confusional state, Delirium, Feeling abnormal, Feeling cold, Feeling hot, Incoherent, Nightmare, Pain of skin, Piloerection, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Long term spinal issues likely due to weakness, spasms, and inflammation in back; asthma; "obesity" by the definition given for 1-C vaccination phase, though I would argue the validity of this particular measure.
Allergies: Allergic to shellfish, crab, shrimp, chocolate, and others.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Around 5:00 PM after having gotten my shot, I arrived home from a drive down to meet my sister. Precautions were taken, masks were worn, safe social distance was maintained and I have no reason to believe any of the symptoms I experienced upon returning home were related to anything other than the vaccine, particularly since first that is how vaccines work and second one of my friends who was vaccinated at the same time as me at the clinic was going through similar pains. It started as a discomfort in my intestines or possibly just below my stomach in general. I thought my pants were too tight but just in case I let my mom take over driving the rest of the way home. When I got to the house, I had about an hour of usable time left before I went into a complete state of delirium. We''re not sure how high my fever actually got before my mom woke up and checked in on me at 9:00 PM, but after having pulled the covers away I registered at 102.5? F. I was screaming in a half-awake and half-asleep nightmare, trying to get someone to come help me and unable to get anyone''s attention. I would, as a result, like to insist that it be added to recommendations to not be alone after getting the vaccine! For the whole first night! I believe that I genuinely could have died. My brain was melting for lack of more proper medical terminology, and I stopped being able to understand and speak my own first language in an incredibly confused state. This was entirely a result of two simultaneous factors: Fever and Chills. First, the fever made my skin ache. Wearing any clothing hurt. But once I took off my pants in exchange for some breezy shorts, I was covered in goosebumps and feeling frozen even though it was solidly in the 70s. I claimed under blankets and still couldn''t get warm enough. The backs of my thighs were insanely hot in comparison to the fronts of them, so I just warmed my body under 3 layers of blankets trying to get the chills to go away. I did that for about four hours during which time I was basically constantly screaming incoherently.


VAERS ID: 1207367 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-17
Onset:2021-04-09
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain lower
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Not quite severe but painful lower left abdominal pain. For 24 hours.


VAERS ID: 1207393 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-03-31
Onset:2021-04-09
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid.25
Current Illness: Hypothyroidism
Preexisting Conditions: diagnosis of epilepsy but without episodes since 2008
Allergies: None
Diagnostic Lab Data: I already notified the staff of my doctor''s office, they agreed to call me back to let me know what I should do about it. They will be consulting the matter with the doctor.
CDC Split Type:

Write-up: On April 9 in the afternoon, a severe headache began, which I had never experienced. This led me to vomit and even then the pain was unbearable. The pain persisted despite taking an analgesic and the next day still felt throbbing that was reflected in the head in general and in the eye area.


VAERS ID: 1207430 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-12
Onset:2021-04-09
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Disturbance in attention, Feeling jittery, Heart rate increased, Hormone level abnormal, Panic attack
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: I am not really sure if its related, and do not want to give false information. I have never experienced a hormonal change the way I did when my period began. This would have been the first cycle after receiving the vaccine. The first day it started, (4/9/21), I felt like I was having a panic attack, anxiety attack or something similar. Now, I do not actually know what these attacks feel like, I am just stating that I assume this is what it feels like. I was not able to focus, felt like I was freaking out, almost as if I had taken some sort of pill that sped up my heart and made me jittery. I just wanted to report, incase others were experiencing the same issue. It lasted only the one day.


VAERS ID: 1207465 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-03
Onset:2021-04-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Muscle spasms
SMQs:, Dystonia (broad)

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

Write-up: cramp in both legs for about 20 minutes from thigh down


VAERS ID: 1207570 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Erythema, Fatigue, Headache, Myalgia, Pain, Pyrexia, Rash pruritic
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Janssen COVID-19 Vaccine EUA Chills and muscle aches began 5.5 hours after vaccine and last for about 3 hours. Extreme chills and aches for 1.5 of those 3 hours. Fever rose to 100 degrees and fell within those 3 hours. Next day experienced minor heachache, body aches, fatigue for entire day. 56 hours after vaccine experienced red itchy bumps across stomach and inside elbows.


VAERS ID: 1207587 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A218 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Severe nausea, syncope, flushing of face and upper body


VAERS ID: 1207635 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Chest discomfort, Dyspnoea, Full blood count, Gait disturbance, Headache, International normalised ratio, Mobility decreased, Pain in extremity, Prothrombin time, Red blood cell sedimentation rate
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: cbc, esr, pt/ptt/inr
CDC Split Type:

Write-up: Started with B leg achiness and pain the day after vaccination. She was having difficulty walking. the second day began having arm pain L$gR to the point she could not lift her left arm. Also has severe headache unable to be treated by otc medicine, chest tightness and some difficulty breathing.


VAERS ID: 1207681 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-22
Onset:2021-04-09
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine, Blood electrolytes, Blood urea, Chills, Differential white blood cell count, Full blood count, Headache, Peripheral swelling, Prothrombin time, Ultrasound abdomen
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin, Welbutrin, Requip, Levothyroxine, Trazadone
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Augmentin
Diagnostic Lab Data: Ultrasound on left leg, Labs: BUN, CBC, Creatinine, Prothrombin Time, Electrolytes, White blood cell differential.
CDC Split Type:

Write-up: 3/22/21- Raging headache, extreme chills. 4/9/21- Left foot swelled up like a grapefruit, was worried about blood clot when I saw them on 4/10/21.


VAERS ID: 1207778 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Dyspnoea, Influenza like illness, Pain in extremity, Syncope, Ultrasound scan normal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED JANSSEN VACCINE ON 4/9/21. 10 HOURS POST-DOSE PATIENT REPORTS FLU LIKE SYMPTOMS AND 4 EPISODES OF SYNCOPE. SHE THEN REPORTS PAIN IN LEGS AND ABDOMEN. ULTRASOUND OF LEGS WERE NEGATIVE FOR BLOOD CLOTS. TODAY 4/14/21 SHORTNESS OF BREATH HAS NOT IMPROVED AND PAIN IN LEGS IN ABDOMEN HAS NOT IMPROVED. PATIENT IS GOING TO ER FOR EVALUATION.


VAERS ID: 1207805 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Electrocardiogram, Fatigue, Malaise, Postural orthostatic tachycardia syndrome, Sinus tachycardia, Ultrasound scan, Urine analysis, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hair supplements
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: EKG, urine tests, ultrasound and others
CDC Split Type:

Write-up: Pt. was very sick the day after the shot, then Friday morning his heart was going into atrial fibrillation and jumping between 110 heart rate and 160+. He was out golfing when he noticed this. He rested later that day but was extremely tired and felt sick. Saturday morning (2.5 days after vaccine) he needed to go to the emergency room because his heart rate was back over 160. The EKG showed sinus tachycardia and gave him a message for it but it made it worse and the rate was over 200. They had to stop and start his heart then put on beta blocker which brought it to 180, then another beta blocker brought to 150. Following EKGs showed atrial fibrillation, postural orthostatic tachycardia syndrome, and super ventricular tachycardia. Pt. had this about a year ago but was fine after a few days. This was the first time he was hospitalized for it and is now on daily medications. He fears the Moderna vaccine triggered it and is very worried about the second dose.


VAERS ID: 1207807 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, COVID-19, Chills, Fatigue, Headache, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlefaxine, Lovastatin, Elmirin, Benazephril, Amlodyphine, hydrochlorothiazide, Metformin, levethyroxine, Fish oil, Multi- Vitamin, Vit B 12, Cslcium
Current Illness:
Preexisting Conditions:
Allergies: Composine
Diagnostic Lab Data:
CDC Split Type: 205A21A

Write-up: I had Covid Dec. 24, 2020. Tge very next day it felt like I had Covid all over again. Chills, tired. 100.8 temperature, headache, body and arms ache and backache. This was the very next day. I felt sick all day and went to bed. Not fun.


VAERS ID: 1207818 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-04-09
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Dyspnoea, Fibrin D dimer normal, Flank pain, Nausea, Pulmonary embolism, Pyrexia, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide, Valsartan, Atorvastatin, and Aspirin
Current Illness: None
Preexisting Conditions: Hypertension, Hyperlipidemia, and CVA
Allergies: Pencillins
Diagnostic Lab Data: 4/9/21 Chest CTA- positive for bilateral PE 4/9/21 Venous doppler study- neg for DVT 4/9/21 D-dimer 35.2
CDC Split Type:

Write-up: Flank chest pain (pain under right rib cage) and Dyspnea on exertion; woke pt up at 0300 on 4/9/21 Chest pain with deep breathing., fever, and nausea upon presentation to ED Pt denied recent travel or prolonged immobilization Patient diagnosed with bilateral pulmonary embolism per CTA


VAERS ID: 1207819 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Appendicectomy, Appendicitis perforated, Blood culture, Blood test, Chills, Computerised tomogram, Headache, Nausea, Pyrexia, Surgery
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine fenofibrate montelukast diclofenac fish oil
Current Illness: None
Preexisting Conditions: high blood pressure
Allergies: None
Diagnostic Lab Data: Blood work 4/13/21 Blood work 4/14/21 CT Scan 4/14/21 Blood culture 4/14/21
CDC Split Type:

Write-up: Symptoms of abdominal pain, nausea, fever, headache, chills began evening of vaccine and proceeded to worsen over the next five days. On April 13 I saw my doctor who ordered blood work. The pain continued to worsen and on April 14 I was admitted to the hospital with a ruptured appendix and had surgery to remove it


VAERS ID: 1207839 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Autoimmune dermatitis, Dehydration, Rash pruritic, Suppressed lactation
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Functional lactation disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins, Vitamin D
Current Illness: No illnesses, but gave birth on 3/17/2021
Preexisting Conditions: Asthma, Vitiligo autoimmune skin disease
Allergies: Pitted fruits
Diagnostic Lab Data: Talked to PCP on the phone and did not seek any further medical intervention.
CDC Split Type:

Write-up: Full body rash began to appear approximately 1 hour after vaccination. Started on chest and spread over entire body. Was very itchy. Came and went and finally disappeared completely after 72 hours. Also experienced dehydration and temporary decline in breastmilk production 24-48 hours after vaccinated.


VAERS ID: 1207905 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-06
Onset:2021-04-09
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral normal, Angiogram pulmonary abnormal, Arteriogram carotid abnormal, Cardiac failure acute, Cardiac failure congestive, Computerised tomogram head abnormal, Condition aggravated, Disorientation, Dysarthria, Dyspnoea, Electroencephalogram normal, Hypotension, Left ventricular dysfunction, Oedema peripheral, Platelet count normal, Polyuria, Pulmonary embolism, Right ventricular dysfunction, Seizure, Subdural haematoma
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Tubulointerstitial diseases (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted on 4/9/21 (unsure where they received J&J COVID vaccine on 3/6/21) Per clinical pharmacist internal event report: Pt received Johnson and Johnson Covid vaccine on 3/6/21. Has chronic sub dural hematomas FYI (seen on scans in Feb). Patient is a 80 y.o. female patient who presented with complaints of dyspnea and BLE edema and was admitted with a principal diagnosis of Acute on chronic congestive heart failure with left ventricular diastolic dysfunction (HCC). Cardiology consulted. Initially diuresed however became hypotensive. Patient had episode of slurred speech and disorientation on 4/11. Code stroke called. CTH with stable SDH. CTA of head had no acute cerebral occlusion. Incidentally was found to have bilateral PEs on CTA h/n. Full CTA chest ordered for further evaluation, noted extensive bilateral pulmonary emboli, associated with Rt heart strain. She was started on heparin drip, Dr. cleared with neurosurgery prior to starting on 4/11 given subacute SDH which has been stable on imaging. Heparin transitioned to eliquis. Additional chart information: ht: 5''4" weight: 108.3 kg CrCl: 50.3 mL/min platelets since admission: 160 - 173 Admission Diagnosis: Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Expected discharge: 4/14/21 Active Problems: Hypertension associated with diabetes (HCC) Gastroesophageal reflux disease without esophagitis Non-insulin dependent type 2 diabetes mellitus (HCC) Seizure disorder (HCC) Dyslipidemia associated with type 2 diabetes mellitus (HCC) OSA on CPAP Pulmonary hypertension due to left ventricular diastolic dysfunction (HCC) Subdural hematoma (HCC) Class 2 obesity due to excess calories in adult Dizziness Acute on chronic diastolic CHF (congestive heart failure) (HCC) Hospital course: Patient is a 80 y.o. female patient who presented with complaints of dyspnea and BLE edema and was admitted with a principal diagnosis of Acute on chronic congestive heart failure with left ventricular diastolic dysfunction (HCC). Cardiology consulted. Initially diuresed however became hypotensive. Patient had episode of slurred speech and disorientation on 4/11. Code stroke called. CTH with stable SDH. CTA no acute occlusion. Suspecting breakthrough seizure. Neuro consulting, EEG normal. Titrating up zonegran - patient will discharge on 100mg in AM and 200mg in PM. Incidentally was found to have bilateral PEs on CTA h/n. Full CTA chest ordered for further evaluation, noted extensive bilateral pulmonary emboli, associated with Rt heart strain. She was started on heparin drip, Dr. cleared with neurosurgery prior to starting on 4/11 given subacute SDH which has been stable on imaging. Heparin transitioned to eliquis. Will need to follow up with PCP. Valsartan was held on admission for hypotension. Blood pressure has remained well controlled off of all antihypertensives. She will need to follow up with PCP for further management of BP, may need valsartan resumed in near future. Patient is medically stable for discharge to home.


VAERS ID: 1207919 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

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

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

Write-up: Woke up middle of night with mild fever and headache. Continuous headache through to 04/10. On 04/11 - Had a migraine with visual aura. On 04/13 - Had a 2nd migraine with visual aura.


VAERS ID: 1207935 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-04-09
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: HTN
Allergies: Doxycycline, Sulfa drugs
Diagnostic Lab Data: SARS-COV-2
CDC Split Type:

Write-up: Dignosed with COVID on 4/9/2021


VAERS ID: 1207952 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: **Jansen COVID-19 Vaccine


VAERS ID: 1208001 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: Sore arm for 2 days and 100.5 degree fever for 6 hours


VAERS ID: 1208078 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin, tylenol, aleve, zyrtec, flonase
Current Illness: receiving knee gel injections
Preexisting Conditions: pre-diabetic, arthritis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: within 24 hours injection site began swelling, became ''hard'' and ''warm'' to the touch, continue to enlarge over the next few days. 4/13/21 saw primary care doctor who said i have an infection. prescribed antibiotic (cephalexin 500 mg) (3 times daily for 7 days) AND mupirocin ointment USP 2% (3 times daily for 7 days). no known allergies.


VAERS ID: 1208094 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Influenza, Nausea, Pain, Pain in extremity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitriptylin Atorvastatin Lorazepam Omeprazole Vitamin D Multivitamin Levothyroxin
Current Illness:
Preexisting Conditions: Cholesterol Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 94/09/2021 at 10:30pm I started running a fever of 99.4. Took extra strength Tylenol. I had chills, some nausea. At 12:15am fever was 101.5. By 9:00am on 04/10/2021 fever had broke but I still felt the after effects of having the flu, aches and pains. On 04/14/2021 I broke out in a red rash on my neck.


VAERS ID: 1208105 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Headache, Myalgia, Nausea, Peripheral swelling, Skin warm, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram; Levothyroxine; Seasonique; Vitamin D; Biotin
Current Illness:
Preexisting Conditions: Endometriosis, Depression, Anxiety, ADHD
Allergies: Nicotine, Ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vertigo, Headache, Nausea, Extreme Muscle Pain. Right arm was swollen, red, and hot for 5 days after.


VAERS ID: 1208110 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline 100 mg, bupropion 300, biotin
Current Illness: none
Preexisting Conditions: depression, anxiety
Allergies: peanut, tree nuts
Diagnostic Lab Data: none
CDC Split Type:

Write-up: severe muscle pain, headache, fever, sweats x 2 days


VAERS ID: 1208147 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

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

Write-up: unexplained bruising with hematoma RUE


VAERS ID: 1208179 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1) ACCU-CHEK GUIDE (GLUCOSE) TEST STRIP USE 1 TEST STRIP ACTIVE FOR TESTING THREE TIMES A DAY (BLOOD SUGAR TESTING) 2) ASPIRIN 81MG CHEW TAB CHEW ONE TABLET BY MOUTH EVERY ACTIVE DAY FOR HEART 3) ATORVASTATI
Current Illness: NA
Preexisting Conditions: 1) ACCU-CHEK GUIDE (GLUCOSE) TEST STRIP USE 1 TEST STRIP ACTIVE FOR TESTING THREE TIMES A DAY (BLOOD SUGAR TESTING) 2) ASPIRIN 81MG CHEW TAB CHEW ONE TABLET BY MOUTH EVERY ACTIVE DAY FOR HEART 3) ATORVASTATIN CALCIUM 10MG TAB TAKE ONE TABLET BY ACTIVE MOUTH AT BEDTIME FOR CHOLESTEROL REPLACES CRESTOR 4) CLONIDINE HCL 0.1MG TAB TAKE ONE-HALF TABLET BY MOUTH ACTIVE EVERY TWELVE HOURS FOR HEART (***CAUTION-TABLET MUST BE SPLIT***) 5) CYANOCOBALAMIN 1000MCG TAB TAKE ONE TABLET BY MOUTH ACTIVE EVERY DAY (VITAMIN B12 SUPPLEMENT) 6) DICYCLOMINE HCL 10MG CAP TAKE ONE CAPSULE BY MOUTH ACTIVE TWICE A DAY AS NEEDED FOR ABDOMINAL PAIN 7) DULAGLUTIDE 1.5MG/0.5ML INJ PEN INJECT 1.5MG (0.5ML) ACTIVE SUBCUTANEOUSLY ONCE A WEEK (DIABETES) 8) DULOXETINE HCL 60MG EC CAP TAKE ONE CAPSULE BY MOUTH ACTIVE EVERY DAY FOR NEUROPATHIC PAIN 9) ERGOCALCIF 1,250MCG (D2-50,000UNIT) CAP TAKE ONE ACTIVE CAPSULE BY MOUTH ON WEDNESDAY (VITAMIN D SUPPLEMENT) 10) FERROUS GLUCONATE 324-325MG TAB UD TAKE ONE TABLET BY ACTIVE MOUTH TWICE A DAY (IRON SUPPLEMENT) 11) FLUTICASONE PROP 50MCG 120D NASAL INHL INSTILL 2 ACTIVE SPRAYS (100MCG) IN EACH NOSTRIL EVERY DAY (RHINITIS) 12) FUROSEMIDE 40MG TAB TAKE ONE TABLET BY MOUTH ONCE A ACTIVE DAY IF NEEDED (WATER PILL) EDEMA 13) HYDROCODONE 5MG/ACETAMINOPHEN 325MG TAB TAKE 1 TABLET ACTIVE BY MOUTH THREE TIMES A DAY IF NEEDED FOR PAIN 14) INSULIN,ASPART 100U/ML NOVO FLEXPEN 3ML INJECT 22 ACTIVE UNITS SUBCUTANEOUSLY BEFORE BREAKFAST AND INJECT 24 UNITS BEFORE LUNCH AND INJECT 18 UNITS BEFORE SUPPER FOR DIABETES 15) INSULIN,DEGLUDEC 200UNIT/ML FLEXTOUCH3ML INJECT 60 ACTIVE UNITS SUBCUTANEOUSLY EVERY DAY (DIABETES) 16) LACTOBACILLUS ACIDOPHILUS TAB TAKE 2 TABLETS BY MOUTH ACTIVE EVERY DAY (MAINTAIN GI FLORA) 17) LISINOPRIL 10MG TAB TAKE ONE TABLET BY MOUTH EVERY ACTIVE DAY FOR BLOOD PRESSURE 18) MAGNESIUM OXIDE 400MG TAB TAKE ONE TABLET BY MOUTH ACTIVE EVERY DAY (SUPPLEMENT) 19) METFORMIN HCL 500MG 24HR SA TAB TAKE ONE TABLET BY ACTIVE MOUTH 1/2 HOUR BEFORE BREAKFAST AND SUPPER FOR DIABETES 20) METOPROLOL TARTRATE 25MG TAB TAKE ONE-HALF TABLET BY ACTIVE MOUTH TWICE A DAY (***CAUTION-TABLET MUST BE SPLIT***) FOR BLOOD PRESSURE 21) OMEPRAZOLE 20MG EC CAP TAKE TWO CAPSULES BY MOUTH ACTIVE TWICE A DAY TO REDUCE STOMACH ACID 22) POLYETHYLENE GLYCOL 3350 ORAL PWDR TAKE 1 CAPFUL ACTIVE (17GM) ACCORDING TO PACKAGE DIRECTIONS ONCE A DAY IF NEEDED (LAXATIVE) FOR CONSTIPATION 23) PREGABALIN 150MG ORAL CAP TAKE ONE CAPSULE BY MOUTH ACTIVE TWICE A DAY FOR NEUROPATHY AND CHRONIC PAIN 24) VARENICLINE 1MG TAB TAKE ONE TABLET BY MOUTH TWICE A ACTIVE DAY (SMOKING CESSATION)
Allergies: PENICILLIN, SULFA DRUGS, VIBRAMYCIN, TETRACYCLINE, DOXEPIN HYDROCHLORIDE AMITRIPTYLINE, NORTRIPTYLINE, CODEINE, FISH OIL, METFORMIN, FENOFIBRATE SHELLFISH, CIPROFLOXACIN, IODINATED CONTRAST MEDIA, FLEXERIL
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Hives


VAERS ID: 1208184 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Fatigue, Headache, Hyperhidrosis, Influenza like illness, Nausea, Pain, Taste disorder, Vision blurred
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: Received the J&J Shot the morning on 4/9. By dinner time, I was feeling nauseous and my body ached. That night was flu like symptoms (chills, sweating, body aches, food tastes funny, etc.). On 4/12 I got a terrible headache, blurry vision, and stomach pains. On 4/13, started to feel better, but stomach still had pains and food tastes funny. Today is 4/14 and I''m am still more tired than usual and still have some stomach pains.


VAERS ID: 1208190 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pain, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: fatigue, body aches, swelling on left side from her neck down to her feet. She reported with these symptoms on Monday 4/12/21, we gave her benedryl to take and some extra to have and recommended she follow up with her primary care phycisian. Symptoms are still ongoing as of 4/14/21.


VAERS ID: 1208255 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, cymbalta, norlyda
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 4/11/21doctors appointment and 4/14/21 doctors appointment
CDC Split Type:

Write-up: Itchy red rash started on legs and spread to entire body day after shot was given. Went to Dr?s was given steroids and rash Intensified each night.


VAERS ID: 1208273 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cosentyx 150mg SQ every 28 days, methotrexate 10mg orally every week
Current Illness:
Preexisting Conditions: Juvenile Idiopathic Arthritis/Ankylosing Spondolytis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient did not meet minimum age requirement of 18 years


VAERS ID: 1208293 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Nausea, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Mainly Nausea with some vomiting for 1.5 days, body aches, chills, sore arm No treatment or doctor visits. Just slept


VAERS ID: 1208362 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Faecal vomiting, Headache, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Requip (restless legs). Xeljanj(stopped taking 2 days before and will not take for a week)Omeperarole,allergy medicine,pilocarpine(dry mouth
Current Illness: none
Preexisting Conditions: acid reflux, dry mouth, restless leg syndrome,rheumoid arthritis
Allergies: sulfa, cymbalta
Diagnostic Lab Data: none did call urgent care for advice
CDC Split Type:

Write-up: later in day extreme headache leg pain nauseous throwing up bile was on couch for 3 days headaches lasted for 2 and a half days throwing up 3 days leg pain first day third day extreme stomach and back pain. still 5 days later still have nausea slight headache and stomach pain


VAERS ID: 1208397 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 25mcg, Crestor 10mg, Omega 3 1 gram, lorazepam 1mg, metformin er 500mg, protonix 40mg
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: penicillin
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient reported that she had welts develop on her body one week after receiving the vaccine. She was going to take benadryl, report to v-safe, and report to her primary physician.


VAERS ID: 1208435 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: pt fainted


VAERS ID: 1208490 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Decreased appetite, Diarrhoea, Dizziness, Epistaxis, Fatigue, Headache, Influenza like illness, Menstrual disorder, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Depo-provera birth control shot, Zyrtec, Magnesium, Zinc, Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet. I see my doctor this afternoon.
CDC Split Type:

Write-up: The day I received the shot, I started to feel severe fatigue, headache, light-headed, and started running a fever about 6 hours after the shot was administered. The next day (4/6) was worse. Severe fatigue, muscle aches, headache, loss of appetite, fever (101.5 was the highest I notice but seemed to be around 101.1-101.3 all day), and general flu like symptoms. However, I also started experiencing abnormal menstrual bleeding. I am on the Depo shot and have been for some time. Due to this, I do not usually experience any menstrual bleeding so I found this to be a little odd. It was not heavy but it was noticeable and contained quite a few clots. Day 3 (4/7) was about the same except my fever came down and ranged from 99.8-101.1. Abnormal menstrual bleeding continued. New side effect this day included diarrhea. Day 4 (4/8) I started to see improvement. No fever (that I could tell). Remaining side effects included mild headache, fatigue, diarrhea, and abnormal menstrual bleeding. Day 5 (4/9), I had one of the worst nose bleeds I''ve ever had in my life. I apologize for the graphic description but it lasted about 20 minutes and my bathroom looked like a crime scene after. Blood was pouring out of my left nostril and I threw two large clots that were about the size of slug (or slightly larger than a fun size snickers... I wish I had a better way to describe it). I''ve had some bad nose bleeds, particularly when I was on Accutane, and this was worse! The rest of the day I felt like I was improving. Energy levels were better. No fever. Menstrual bleeding stopped. Only lingering side effect was mild headache and mild diarrhea. Since then I''ve continued to feel better and the diarrhea seems like it''s improving. Mild headache persists. Only new item is an annoying twitch in my left eye that started on Monday (4/12).


VAERS ID: 1208539 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry skin, Pruritus, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine 5 mg, enalapril 10 mg, levothyroxine 112 mcg, vitamin D, metamucil
Current Illness: none
Preexisting Conditions: Hx of previous breast cancer, hypertension and hypothyroidism
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pruritic rash over lower back. Red, dry, slightly raised 18 x 12 cm Micro-papular rash over upper abdomen, diffuse and subtle. The itching over lower back was intense for 3 nights but now seems to be subsiding on its own. No prescription medications were required. Patient was advised to use emollients and topical steroid or Benadryl prn if itching returned. Monitor clinically.


VAERS ID: 1208542 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Pain, Pain in extremity
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called the pharmacy on 4/14/2021 to report a throbbing in her left shoulder which radiates down to her elbow. This is the arm she received the vaccine in. The throbbing began on 4/9/2021 after receiving the vaccine on 4/7/2021. The pain has not resolved as of 4/14/2021. We advised her to consult her primary care physician.


VAERS ID: 1208549 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: After receiving J & J Covid vaccine, client stated she felt weak and dizzy. After sitting for a few minutes, assisted client to lie down on couch. Client was diaphoretic. BP 88/68. Legs elevated and given a few sips of juice. BP rechecked at 100/70. Client was well enough to transfer to observation area. Client waited another 15 minutes and left on her own with no further complaints.


VAERS ID: 1208571 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: urticaria


VAERS ID: 1208631 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: School       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling cold, Nausea, Night sweats, Pain, Pain in extremity, Piloerection
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: After about 7 hours of receiving the vaccine I started to shiver. My body felt extremely cold even though I was in 75 degree temperature indoors. I started getting goosebumps. That lasted for about 9 hours throughout the night. I also experienced nausea for about 30 minutes at 8:45 pm. I felt like I was going to pass out within that time period too. My head was also hurting throughout the night. My body was aching through the night as well. The only reason I am not sure if I had a fever is because I did not have a thermometer. My arm was sore for 3 days and I was also sweating throughout the first night.


VAERS ID: 1208639 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dysphonia, Fatigue, Oropharyngeal pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Unknown time-Flu-
Other Medications: Genivua, Farciegia, Clortmomeride, Trocevia, Decolicant, Crestor, prilia, Vit D.
Current Illness: no
Preexisting Conditions: Diabetes, IBS, Diverticilitis, High Cholesterol, Migranes, GERD
Allergies: Erythromycin, fish, nuts, metrotrexosate, all fruits, okra
Diagnostic Lab Data: COVID-19-neg
CDC Split Type: vsafe

Write-up: Later the day after the vaccine I developed severe chills and a really bad sore throat. I developed hives in my throat and mouth which cause hoarsness and was hurting really bad. On that Monday I visited my PCP who prescribed an antibiotic which did help and took antihistimines also. I developed a fever an was really tired and after about 3 day the symptoms subsided. My arm was really sore for about 2 days also.


VAERS ID: 1208671 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Injection site swelling, Myalgia, Night sweats, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Immunity, Vitamin C, Lisinopril, Low dose aspirin
Current Illness: None
Preexisting Conditions: None
Allergies: , None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, Chills, Night Sweats, Muscle aches, Fatigue, Swelling at vaccination site Lasted 48 hours


VAERS ID: 1208737 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Heart rate increased, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (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), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Low Dose Aspirin, Vitamin C, D3, K2, Zinc, Calcium
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: Macrobid
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, chills, muscle aches, rapid heart rate, pain in rib cage, pain at injection site Lasted for about 48 hours


VAERS ID: 1208738 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Headache, fever/chills, nausea. Lasted for about 13 hours


VAERS ID: 1208778 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-25
Onset:2021-04-09
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Has a history of malignant melanoma.
Preexisting Conditions: Malignant melanoma Chemo and immunnotherapy
Allergies: None
Diagnostic Lab Data: Patient had CTA chest that confirmed it.
CDC Split Type:

Write-up: patient has bilateral pulmonary embolism


VAERS ID: 1208781 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Sinus and allergies
Allergies: Penicillin, latex, pollen, dust, weeds, trees, crabgrass, mold, dog dander.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Shortness of breath followed by fatigue, chills, fever and entire body aches.


VAERS ID: 1208937 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: starting friday april 9th 2021, after patient recieved vaccination she has had a headache on the left side of her head. the headache has been continuous and is not relieved by pain medication


VAERS ID: 1208960 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Hyperacusis, Magnetic resonance imaging head, Migraine, Photophobia, Ultrasound scan, Varicose vein
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertaline (100 mg), Allergera for allergies, women multi-vitamin, B12 vitamin
Current Illness: none
Preexisting Conditions: Anxiety
Allergies: Baxtrum
Diagnostic Lab Data: On April 13, 2021, Emergency Room performed an ultra sound on left leg and found a blood clot. Hospital also performed an MRI on brain and brain vessels/sinus vessels and found no clot. On Covid-19 Vaccination Record Card, there is another number listed that may help assist: NDC 59676-580-15 Lot:1805020
CDC Split Type:

Write-up: Had Janssen shot on April 2, 2021. No issues whatsoever until April 9, 2021 when I began having a horrible blinding migraine. Sensitive to light and noise. No over counter headache medicine was helping. Same night, a painful blue line, (like varicose vein) formed in left calf. On Tuesday, April 13, 2021 went to Dr. office who agreed that these reactions are a concern and went to Hospital.


VAERS ID: 1208963 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diclofenac sodium Topical gel 1%, Triamcinolone acetonide cream 1%, latanoprost solution .005%, pseudoephedrine hydrochloride, cetirizine, famotidine, Sam-e, St. John''s Wort, zinc, potassium
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Felt fine for hours while sitting at computer and then I got a feeling that I had never had before in my life. It felt as if there was an elephant sitting on my chest. No real pain. No panting. Just a real heavy chest. It is not heartburn or upset stomach - I know how that feels. It was uncomfortable and notice I got a look of distress in my face. That''s when I laid down on the couch with feet up and put my hands above my head towards the floor. After about 1.5 hours, the feeling went away. Haven''t had anything else since then.


VAERS ID: 1208989 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21H / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Eructation
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: mild abdominal pain starting one days after injection, then developed into stomach discomfort. On April 11-12 (4 days after injection), my stomach burped a lot.


VAERS ID: 1209014 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Diarrhoea, Pain, Pain in extremity
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Dehydration (narrow)

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

Write-up: Diarrhea, mild temperature, sore body initially. 3 days after pain in right leg. It feels like a sharp stabbing pain. Like a charley horse or dehydration. Drank water and Gatorade does not stop pain. Started to take 81 mg aspirin and did not stop pain. Just went to Dr. for blood test on 4/14/21.


VAERS ID: 1209030 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043 A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bradyphrenia, Chest X-ray, Chest pain, Chills, Dizziness, Dyspnoea, Headache, Heart rate increased, Hyperaesthesia, Hypoaesthesia, Nausea, Pain, Painful respiration, Sleep disorder, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse Escitalopram Propranolol Birth control pill Myocycline
Current Illness: None
Preexisting Conditions: ADHD Depression Anxiety PMDD
Allergies: None
Diagnostic Lab Data: Chest X Ray 04/10/2021
CDC Split Type:

Write-up: Started out with a headache and dizziness within a few minutes of the vaccine, along with nausea. I stayed put laying down with a lollipop and water bottle along with ice packs on me for about an hour until I was well enough they thought for me to drive back to my dorm. Once I started driving the headache was back but I was driving so I couldn?t do much. Almost pulled over because I was getting over whelmed but ended up making it back to my dorm. Once I got back I changed and laid down in bed hoping to fell better. Things started getting worse from there. Throughout the rest of the day my head ache and dizziness got worse to the point where I was pretty unsteady on my feet. Chills and body aches also started and progressed rapidly despite no fever. My nausea was present in waves but eventually dissipated around 8 PM. I tried to go to bed around 11 hoping to sleep off the symptoms. I began tossing and turning. My chills were really bad and it got to the point where my skin was so sensitive that the clothes I was wearing touching and rubbing against my skin were hurting me. I was so dizzy and light headed to the point where it didn?t matter if I was laying down or sitting up, I felt the same, extremely dizzy and lightheaded as if cotton were in my brain or as if it were working too slow. It was like trying to process thoughts through molasses. Then around 1:30 I couldn?t take it anymore and thought maybe a quick shower would help me to at least feel better so I could sleep. When I got in the shower I immediately knew things were worse. My vision started going black at the edges and black spots in the middle to the point where at certain moments I couldn?t see. I was fighting to stay on my feet and conscious and it was hurting to breathe. I knew I needed to get help so I stumbled to my dorm and collapsed when I got in the doorway to my room. My vision was spotty, my chest was hurting and I could barely breathe. My hands and feet went numb as well, I was shivering, and my body temperature was a little down to about 98.1 degrees Fahrenheit. I was transported to a hospital via ambulance my vitals were normal except elevated heart rate and O2 and was admitted at 2:40 in the morning. I received a chest x ray and my heart rate was better. The dizziness was under control by then. I was discharged at 4:50 in the morning.


VAERS ID: 1209136 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dyspnoea, Electrocardiogram, Intranasal paraesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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: ESCITALOPRAM, TRI-SPRINTEC
Current Illness:
Preexisting Conditions:
Allergies: CODEINE
Diagnostic Lab Data: RESULTS FAVORABLE PER PATIENT
CDC Split Type:

Write-up: TINGLING SENSATION IN BOTH ARMS UP TO SHOULDERS, TINGLING SENSATION IN NASAL SINUSES, LABORED BREATHING. HOSPITAL VISIT REQUIRED; LITER OF FLUID, 2 EKGS, BLOODWORK, CT SCAN. 5 HOURS VISIT AT HOSPITAL


VAERS ID: 1209148 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling hot, Hyperhidrosis, Malaise, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: needle phobias, has experienced fainting and feeling anxious and unwell from prior vaccines
Other Medications: NONE
Current Illness: NEEDLE PHOBIA, ANXIOUS
Preexisting Conditions: NONE KNOWN
Allergies: NONE
Diagnostic Lab Data: n/a
CDC Split Type: 1

Write-up: The patient had a needle phobia and was very anxious prior to the vaccine. Once the patient received the vaccine, he waited in the waiting area for 15 minutes post-vaccine. About 5 minutes after the vaccine, he notified the pharmacy staff that he wasn''t feeling well and he was feeling faint. The pharmacy staff provided him with a glass of water and was monitoring him. He said he felt like he fainted and wasn''t feeling well. He said he felt warm and sweaty. The pharmacy staff provided him with an ice pack. He then notified the pharmacy staff that he urinated in his chair while waiting post-vaccine. He wanted to be checked out and wanted us to call 911 . The patient began to feel better after about 20 minutes. The EMT arrived and checked the patient. Even though, the patient was feeling better, the EMT recommended the patient be checked further anyways. He was brought to the Triage center and was there for about 1 hour, according to the patient, and was feeling better. He said he felt slightly fatigued that day and the following day, but other than that he was feeling back to normal and no issues. He stated he has severe needle phobia and has experienced these fainting spells and anxiousness in the past. We followed up with the patient and he provided this information to us. He stated he was feeling good and back to normal. He had no further questions or concerns. We told him to follow up with us if questions or concerns came up.


VAERS ID: 1209167 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN042A21A / N/A LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea haemorrhagic, Haematochezia, Laboratory test normal, Rectal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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: ALLOPURINOL 300 MG Q DAY , HCTZ 25 MG Q DAY , AMLODIPINE 10 MG Q DAY , BUPROPION 300 MG XL Q DAY, HYDROXYZINE 25 MG QHS ,BUSPIRONE 15 MG TID , PRAZOSIN 2MG Q HS ,CLOTRIMAZOLE SOLN BID
Current Illness: NONE
Preexisting Conditions: GOUT , HTN , PTSD, OSA, OBESITY ,SUBCLINICAL HYPERTHYROID, ,KERATOCONUS
Allergies: NONE
Diagnostic Lab Data: WENT TO LOCAL ER REPORTS LABS NORMAL
CDC Split Type:

Write-up: TWO DAY AFTER VACCINE PATIENT HAD SEVERE LOWER ABDOMINAL CRAMPS AFTER AHVING MILK SHAKE AND ON 4/9/21 HE HAD RECTAL BLEEDING X 3 FIRST TIME BLOOD MIXED WITH STOOL ,SECOND TIME BLOODY DIARRHEA .THIRD TIME BLOOD


VAERS ID: 1209204 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Severe headache, fever for the first two days and chest pain, fatigue


VAERS ID: 1209210 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201AZ1A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Dizziness, Fatigue, Muscular weakness, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Fish Oil, Tramadol 50 mg
Current Illness: None
Preexisting Conditions: 5 herniated disk on my column
Allergies: Milk products Lactose and Cassein.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Nausea, Some Vomit, Stomach Upset, Stomachache, Mild but continuous Dizziness, Severe Fatigue, Muscle Weakness


VAERS ID: 1209217 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER872A / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood urine, Cerebral haemorrhage, Computerised tomogram head abnormal, Contusion, Epistaxis, Immunoglobulin therapy, Mouth haemorrhage, Platelet count decreased, Thrombosis, Tongue haemorrhage
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (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? 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: NIDDM, Hypothyroidism, Grade IV right temporal glioblastoma diagnosed in 2016 (received chemotherapy and radiation.)
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: 4/11/21 Platelets - 3,000.
CDC Split Type:

Write-up: 4/9/21-30 minutes to 1 hour after receiving 2nd dose of vaccine patient had bloody nose, clots, with bleeding sores on tongue and side of mouth. Began to have bruises on arms, feet and legs. Blood in urine and bruises on back. Presented to emergency department on 4/11/21. CT brain revealed a right sided posterior temporal hemorrhage. Patient was emergently treated with platelets, DDAVP, factor VII, Decadron, IVIG. 4/12/21, patient denies headache, changes in vision, double vision, change in sensation, including burning, pinprick, numbness, no focal or motor weakness. No change in bowel or bladder control. No sensory changes. Patient states she is now back to her normal state of health, save for the bruising described.


VAERS ID: 1209312 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Eye swelling, Headache, Muscle spasms
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Glaucoma (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? No
Previous Vaccinations:
Other Medications: Cough syp Saline nasal spray Lipitor 10 ,g triamcinolone oint tylenol 325 mg Cetirizine 10 mg
Current Illness: none
Preexisting Conditions: Hyperlipidemia Allergic Rhinitis
Allergies: Tetracycline
Diagnostic Lab Data: Advised to call 911: declined opted to drive herself to Hospital
CDC Split Type:

Write-up: Severe Headache 10/10 started 1 day after injection Swelling and pain of 1 eye leg cramps


VAERS ID: 1209369 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Magnetic resonance imaging head normal, Migraine, Thrombosis, Ultrasound scan abnormal, Vein disorder
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (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: Setraline 100mg daily, Zertek, women''s multi-vitamin
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: Baxtrum
Diagnostic Lab Data: Went to doctors office and Hospital on April 13, 2021 and emergency room performed an ultra sound on leg and found a blood clot. Emergency room also performed MRI of brain and sinus without any signs of blood clot.
CDC Split Type:

Write-up: On April 2, 2021 the Janssen shot was provided with no adverse events. On April 9, 2021, a sever migraine developed along with a blue line in left leg.


VAERS ID: 1209376 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest discomfort, Chills, Dyspnoea, Dysstasia, Gait disturbance, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xifaxan 550mg Ibuprofen 200mg
Current Illness: Chronic diarrhea of unknown origin, being treated with Xifaxan as possible SIBO
Preexisting Conditions: Chronic diarrhea Polycystic Ovary Syndrome
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day after receiving the vaccine, I experienced common side effects of fever, chills, body aches, and nausea, which lasted for 24 hours, and then I felt better. Then, 3 days after receiving the vaccine, I suddenly began to have extreme stomach pain, so bad that I could barely walk or stand up straight. My chest felt tight and I had shortness of breath. I thought about going to the ER, but called my GI specialist instead as I thought it could be related to the Xifaxan I was taking, but the office was already closed. The GI office called the following Monday and said the Xifaxan should not cause extreme stomach pain and to go to the ER if it persists, but by this time I was feeling much better. The severe pain lasted two days in total.


VAERS ID: 1209399 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Asthma
Allergies: inhaler (not sure of name) reports hasn''t used inhaler in over a year
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient is 17 years old. EUA for Janssen vaccine is for 18 years and older and vaccine was administered to a patient who was under 18 years old


VAERS ID: 1209401 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women''s multi-vitamin, week off but Microgestin
Current Illness: None
Preexisting Conditions: None
Allergies: Non
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed a headache by the next morning after the shot. Within 27 hours I began to develop a fever, which went up to 104.5 at it''s peak - stayed there for about 8 hours, as well as severe chills and aches. The fever came down into 101 range around 11 pm, and woke up without a fever, but maintained some fatigue and light headache the following day. I took some Ibuprofen when I woke with the headache but did not take any more after the morning dose.


VAERS ID: 1209451 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Neck pain, Pain, Pain in jaw
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (broad)

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

Write-up: Severe throbbing pain in center of chest, jaw pain and severe pain on right side of neck through the night starting about 12 hours after the injection.


VAERS ID: 1209504 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium + Vitamin E supplement; daily organic multi-vitamin
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Lidocaine (rash); erythromycin (nauseau); pineapple (food intolerance)
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the Janssen COVID-19 Vaccine EUA on Thursday morning. April 8, . Six hours later I had chills and a low grade fever for two hours. Then, thoughout the night, I experienced jaw pain making it difficult to sleep, but in the morning I applied ice and the pain went away. By Sunday, I felt 100% better.


VAERS ID: 1209580 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Axillary pain, Diarrhoea, Hypoaesthesia, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: - within the first 30-40 minutes: I could feel numbness creep up my arm on the side of the injection. It traveled as high as my eyebrow. It felt much like an injection would if you were getting a filling at the dentist. I couldn''t see any swelling or puffiness but definitely numb. This passed within the first few hours. - first two days - I was very sore and achy in my muscles all over my body, but on the third day it was centralized to just the muscles on my upper arm and under the arm kinda into the "peck" area I believe it would be called. - day 6 - today I have mild diarrhea and a slight upset stomach.


VAERS ID: 1209638 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol 25mg daily, clonidine 0.1mg daily, Depo-testostorone
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Physical examination
CDC Split Type:

Write-up: Facial paralysis/Bell''s Palsy


VAERS ID: 1209641 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Deep vein thrombosis, Dyspnoea, Fibrin D dimer increased, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pantoprazole, Pravastatin, Paroxetine
Current Illness: None
Preexisting Conditions: Chronic lymphocytic leukemia, History of prostate cancer--s/p prostatectomy, Hyperlipidemia, depression with anxiety
Allergies: None
Diagnostic Lab Data: D-dimer 9800 Lower extremity ultrasound positive for femoral vein DVT. CTA of chest- positive for bilateral lung pulmonary emboli in each lung lobe with left lower lobe infarction
CDC Split Type:

Write-up: patient was administered Moderna vaccine (initial shot) and within 48-72 hours became short of breath. He presented to my office for evaluation 4/14/2021 and found to have right leg DVT and massive bilateral pulmonary emboli with left lung infarction.


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=75&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166