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From the 11/19/2021 release of VAERS data:

Found 8,669 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit

Government Disclaimer on use of this data



Case Details

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VAERS ID: 1728846 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-08-28
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 UN / UN

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

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

Write-up: Treated for COVID symptoms and positive test in ED. Fully vaccinated April 2021.


VAERS ID: 1729014 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-09-06
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 UN / UN

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

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

Write-up: COVID positive, seen in ED for treatment. Fully vaccinated April 2021.


VAERS ID: 1729023 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-09-06
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 UN / UN

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

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

Write-up: Seen in ED for COVID 19 symptoms and positive test. Fully vaccinated April 2021.


VAERS ID: 1729053 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-01
Onset:2021-09-10
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adverse reaction, Angiogram, Chest X-ray, Chest discomfort, Electrocardiogram, Laboratory test, Mouth swelling, Ocular hyperaemia, Oropharyngeal pain, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypersensitivity (narrow)

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: Birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 9/11/2021: EKG, labs, chest xray, CTA of the chest
CDC Split Type:

Write-up: On 9/10, 9 days after vaccination, I developed tightness in my chest mid morning as well as a mild sore throat. I left work. Went home, slept, woke up around 2:00 with persistent tightness in my chest and sore throat. I rested. That evening I woke up in the night, the left side of my mouth was swollen and my left eye was bloodshot. I put an ice pack on my face and went back to sleep. Next morning, I woke up (9/11), still had tightness in my chest and a sore throat and additionally my hands and feet were swollen. It was painful to walk and open and close my hands. I went to immediate care. They ran an EKG, labs, did a chest X-ray. EKG and chest xray came back clear but my labs revealed a d-dimer value of $g3,800 (normal <400) which they said was indicative of me possibly having a pulmonary embolism, especially because I had just gotten the J&J vaccine. I was sent to the hospital immediately. They did additional blood work, EKG, and a chest CT which revealed no PE. I was told it was likely just a bad vaccine reaction and sent home. I followed up with my PCPs office on 9/20 who also believed it was an adverse vaccine reaction.


VAERS ID: 1729083 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-30
Onset:2021-08-23
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted for AKI and covid positive test


VAERS ID: 1730161 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Electroencephalogram, Hypoaesthesia, Magnetic resonance imaging, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Asthma; Latex allergy (Hives experienced due to Latex allergy); Non-smoker; Sulfonamide allergy (Rash head to toe experienced due to Sulfa allergy)
Preexisting Conditions: Comments: The patient did not have any drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Magnetic resonance imaging; Result Unstructured Data: not reported; Test Date: 202104; Test Name: Electroencephalogram; Result Unstructured Data: not reported
CDC Split Type: USJNJFOC20210936238

Write-up: VISUAL DISTURBANCE; NUMBING OF ARMS; This spontaneous legal case report received from a parent via social media concerned a 32 year old white and unknown ethnic origin female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: asthma, latex allergy, sulfa allergy, non alcohol user, and non smoker, and other pre-existing medical conditions included: The patient did not have any drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978 expiry: UNKNOWN) dose was not reported, 1 total administered on 25-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the patient went through EEG(electroencephalogram) and MRI (magnetic resonance imaging) with unknown results to determine a diagnosis. On 13-APR-2021, the patient experienced visual disturbance and numbing of arms and visited an ophthalmologist to look at her vision quality and also visited the emergency room(ER). The patient went to 3 different hospitals. The patient was being seen at Hospital at the time of reporting. The patient was not receiving the care she needs from the hospital. On an unspecified date, the patient was hospitalized. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from visual disturbance, and numbing of arms. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: Medical Assessment Comment is not required as per standard operating procedure for legal case.


VAERS ID: 1730175 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-02
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Fatigue, Headache, Laboratory test, Pain in extremity, Platelet count, Pulmonary embolism, Pyrexia, Thrombocytopenia, Thrombosis
SMQs:, Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: Body temperature; Result Unstructured Data: 101.3 F; Test Date: 20210904; Test Name: Body temperature; Result Unstructured Data: 100.8 F; Test Date: 20210909; Test Name: Platelet count; Result Unstructured Data: Low; Test Date: 20210909; Test Name: Lab test; Result Unstructured Data: diagnosed with blood clot, bilateral PE with thrombocytopenia; Comments: diagnosed with blood clot, bilateral pulmonary embolism with thrombocytopenia (low platelets).
CDC Split Type: USJNJFOC20210941148

Write-up: BLOOD CLOT; BILATERAL PULMONARY EMBOLISM; THROMBOCYTOPENIA; PAIN IN LEFT THIGH; EXHAUSTION; FEVER; SEVERE HEADACHE; This spontaneous report received from a consumer concerned a 37 year old male of unknown race and ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included controlled high blood pressure. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: Unknown) dose was not reported, 1 total, administered on 24-AUG-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 02-SEP-2021, the patient started having severe headache. On 04-SEP-2021, the patient had pain in left thigh, shortness of breath, 2 episodes of fever and exhaustion. On 09-SEP-2021, the patient was admitted to the Intensive Care Unit (ICU) and according to reporter, patient was diagnosed with blood clot, bilateral pulmonary embolism and thrombocytopenia(low platelets). The reporter stated that according to the doctors the events were related to the vaccine. The patient had done genetic testing and was negative for any clotting disorder. The patient spent two days in inflammatory floor from 11-SEP-2021 to 13-SEP-2021 and was discharged on 13-SEP-2021. The reporter mentioned that the patient almost died and was told at the ICU (intensive care unit) that it was a miracle that the patient was still alive. The reporter also stated that the patient could not receive any COVID-19 vaccine or booster shot anymore. Laboratory data included: Body temperature (NR: not provided) 101.3 F, 100.8 F. Laboratory data included: Lab test (NR: not provided) diagnosed with blood clot, bilateral pulmonary embolism with thrombocytopenia (low platelets) and Platelet count (NR: not provided) Low. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the bilateral pulmonary embolism, thrombocytopenia, blood clot, fever, severe headache, pain in left thigh and exhaustion was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210941148-covid-19 vaccine ad26.cov2.s-bilateral pulmonary embolism, blood clot, thrombocytopenia. This event(s) is labeled per RA and is therefore considered potentially related.


VAERS ID: 1730178 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-14
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ultrasound scan vagina, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Breast cancer (Breast Cancer 2007); Endometriosis; Lung cancer (Lung cancer 2002)
Preexisting Conditions: Comments: Patient had history of fertility treatments for 8 years in 1960s.
Allergies:
Diagnostic Lab Data: Test Name: Transvaginal ultrasound scan; Result Unstructured Data: Normal; Test Name: Transvaginal ultrasound scan; Result Unstructured Data: Not reported
CDC Split Type: USJNJFOC20210942041

Write-up: VAGINAL BLEEDING; This spontaneous report received from a patient concerned an elderly, white, female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: lung cancer (2002), breast cancer (2007) and endometriosis, and other pre-existing medical conditions included: patient had history of fertility treatments for 8 years in 1960s. The patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration was not reported, batch number: Unknown, and expiry: Unknown) dose was not reported, one total administered on 09-APR-2021 to left arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. Five days after vaccination, on 14-APR-2021, the patient began bleeding vaginally. The patient had bleeding again on an unspecified date, was admitted to the hospital on 20-APR-2021, stayed several days and received a blood transfusion. The patient was discharged from hospital on an unspecified date in APR-2021. The bleeding resolved after the hospital stay and patient had two transvaginal ultrasounds, the second being only a few weeks ago, with appearing normal results. The results of the first transvaginal ultrasound scan was not reported. On an unspecified date the patient visited emergency room/department. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vaginal bleeding on APR-2021. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210942041- Covid-19 vaccine ad26.cov2.s- Vaginal bleeding. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY


VAERS ID: 1730194 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-09-11
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Adverse drug reaction, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: COUMADIN
Current Illness: Primary pulmonary hypertension
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210943918

Write-up: ADVERSE EVENT NOS; FEVER; This spontaneous report received from a patient concerned a 78 year old female. The patient''s weight was 72.7 kilograms, and height was not reported. The patient''s concurrent conditions included: primary pulmonary hypertension. The patient received macitentan (tablet, oral, batch number: ZE023B0301 expiry: 30-APR-2025) 10 mg, 1 time every 1 day, therapy dates were not reported for an unspecified indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included warfarin sodium. On 11-SEP-2021, the patient experienced adverse event nos. On 11-SEP-2021, the patient experienced fever. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable; and dose of macitentan was not changed. The outcome of the adverse event nos and fever was not reported. This report was non-serious.


VAERS ID: 1730979 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-24
Onset:2021-09-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204321A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Body temperature increased, Chills, Electrocardiogram normal, Electrolyte imbalance, Fatigue, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Asthma (seasonal)
Allergies: No
Diagnostic Lab Data: EKG at hospital was clear. They did not order blood work gave me more fever relief medications and put me on fluids because there was an electrolyte deficiency.
CDC Split Type:

Write-up: Around 7:30 I began to have chills and slight back ache. In the hour following both got worse and I had full body aches. By 10:30pm after I had taken ibuprofen my temperature was 105.6 degrees and had a constant heart rate over 160bpm. I felt fatigued and shaky and had someone take me to hospital.


VAERS ID: 1731197 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-09-19
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Asthenia, Blood pressure increased, Dry eye, Dyspnoea, Fatigue, Mood altered, Pain, Palpitations, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Depression (excl suicide and self injury) (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Extreme anxiety, heart racing, both feet were throbbing, shortness of breath, blood pressure rocketed 190/112, dry eyes, two finger shaking, weakness, tiredness, fatigue and moody.


VAERS ID: 1731247 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-03-17
Onset:2021-09-05
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Candesartan, Warfarin, Carvedolol
Current Illness: none
Preexisting Conditions: Marfan''s syndrome. Both aortic and mitral valves have been replaced with mechanical valves.
Allergies: none
Diagnostic Lab Data: EKG, chest X-ray, and whatever bloodwork they ran. This was done at the emergency room.
CDC Split Type:

Write-up: Atrial fibrillation. Lasted several hours. Went to the ER to make sure I wasn''t going to die. They did some tests then sent me home. Condition was gone by the time I woke up. This is very likely not related to anything other than my medical history but thought you should have the data.


VAERS ID: 1731280 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-27
Onset:2021-09-09
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: CSF protein normal, Chronic inflammatory demyelinating polyradiculoneuropathy, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness, Paraesthesia, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Labetalol, trazodone, Lexapro, doxazosin
Current Illness: alcohol abuse, depression, enlarged prostate, HTN
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data: CSF protein 41, WBC 0
CDC Split Type:

Write-up: Per notes, Probable Guillain-Barr? syndrome/CIDP related to Covid vaccination. Patient came in with tingling and numbness, weakness in arms and legs, some difficulty swallowing


VAERS ID: 1731451 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-08-18
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Confusional state, Cough, Death, Dyspnoea, Hypoxia, Pneumothorax, Positive airway pressure therapy, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-24
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt tested positive for COVID on 8/18; presented to ED on 8/24 hypoxic with confusion, SOB, coughing; placed on BIPAP; pneumothorax occurred; condition worsened where patient died in hospital


VAERS ID: 1731515 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-22
Onset:2021-07-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Axillary pain, Cellulitis, Dyspepsia, Dysstasia, Erythema, Groin pain, Neck pain, Oropharyngeal pain, Pain, Pain in extremity, Petechiae, Pruritus, Pyrexia, Rash, Skin warm
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I had fever, body aches, sore throat for 5 day. Developed pain in upper right stomach area and heart burn. After 2 weeks I developed petechiae over the bicep of left arm and on both shins. The heart burn and pain in stomach continued to get worse, and itching on the skin of the upper stomach had started. On Aug 24, I woke with a sore throat at 1 AM. I woke again at 6 AM with shin of my right leg hot, and a red spot 14mm in size. I had aches all over my body, and pain in my neck, under arms, in groin. It was extremely painful to stand. I could not find medical help until Aug 25, 2021. The spot on my leg had gotten bigger and painful. I was diagnosed with Cellulitis. I started a course of Bactrim DS . On Day 10 of antibiotics 9/4/2021, i woke covered in a rash all over my body. I could not get medical assistance. I stopped antibiotics, started to take Benadryl for 5 days. I was finally able to see my MD on 9/10. The rash for the antibiotics finally disappeared on 9/15/21. In the mean time, the petechiae, the stomach skin itching, and Cellulitus resolved. I''m finally feeling better, 2 months later


VAERS ID: 1731525 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-08-19
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19 pneumonia, Death, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-29
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: hx of pituitary adenoma - post surgical resection back in April 2021; presented to ED with weakness and SOB, positive for COVID - 19; pt''s condition worsened where he passed away in the hospital; Acute hypoxemic respiratory failure secondary to COVID pneumonia


VAERS ID: 1731630 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-08
Onset:2021-04-01
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Facial paralysis, Headache, Hypoaesthesia, Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 30 mg
Current Illness: Fibromyalgia
Preexisting Conditions: Fibromyalgia
Allergies: NKDA
Diagnostic Lab Data: Cat scan done - was clear
CDC Split Type:

Write-up: 2-3 weeks after started having numbness and tingling to left side of body - face tingling and left eye dropping and twitching had started in June and has gotten more intense with headaches to left side of head.


VAERS ID: 1731636 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 LA / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness postural, Headache, Hypoaesthesia, Myalgia, Nausea, Paraesthesia, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: unknown
Preexisting Conditions: none
Allergies: Penicillin
Diagnostic Lab Data: Sed rate-30
CDC Split Type:

Write-up: This is a 33-year-old female who presents with complaints diffuse and not improving headache and myalgias x2 days after receiving Johnson & Johnson Covid vaccine on 9/7/2021. Patient received injection in her left arm and states she has since experienced intermittent paresthesias beginning in her left fingers radiating across her shoulders and into her right upper extremity. She also reports numbness of her bilateral legs when sitting that improves with positional changes as well as intermittent dizziness associated with positional changes, predominantly from sitting to standing. Patient''s headache is diffuse, moderate and characterized as aching in nature which remains unchanged with over-the-counter Tylenol. There is associated nausea without vomiting which the patient is treating with Zofran without relief. She is unable to take over-the-counter ibuprofen due to history of gastric sleeve. There is no associated diarrhea, cough, congestion, fever/chills, shortness of breath or chest pain. Headache not associated with photophobia, diplopia or other visual disturbances. She denies near syncopal or syncopal episodes.


VAERS ID: 1731641 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-23
Onset:2021-09-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest discomfort, Chest pain, Pain, Paraesthesia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, medroxyprogesterone
Current Illness:
Preexisting Conditions:
Allergies: Seafood, Shellfish
Diagnostic Lab Data: Patient tested positive for SARS-CoV-2 on arrival to the ER.
CDC Split Type:

Write-up: Tingling in arms and legs accompanied by chest tightness. Escalated to entire body and chest pain. Received vaccine around 2 pm per patient and symptoms started around 9pm. Around 10pm the chest tightness started. Patient received Benadryl, iopamidol, lorazepam, solumedrol, and Reglan on 9/24/21. Patient discharged by attending in stable condition.


VAERS ID: 1731741 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-06-01
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamins.
Current Illness:
Preexisting Conditions: COPD
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Suffered a stroke, hospitalized for 2 weeks.


VAERS ID: 1731818 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-23
Onset:2021-09-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Chest pain, Chills, Electrocardiogram, Fatigue, Feeling cold, Headache, Hyperhidrosis, Limb discomfort, Peripheral swelling, Photophobia, Pruritus, Pyrexia, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt not taking any medications at time of vaccination ; however takes PRN: proair inhaler, melotonin, benadryl, zofran
Current Illness: N/A per pt
Preexisting Conditions: asthma, ulcerative colitis, GI specialist expanded esophagus 5+ yrs ago per pt
Allergies: NKA
Diagnostic Lab Data: EKG at Emergency Room -Normal Sinus Rhythm per nurse at ER No other labs or test due to not being seen by provider
CDC Split Type:

Write-up: a two nurse assists to pivot pt to cot; pt laid at a 60 degree and, and moved to a 90-degree angle to drink Gatorade; she stated her legs felt ?heavy?, and ?tingled?; she complained of being cold, and towels were put on pt; pt stated this helped. pt requested to use the bathroom, and had some improvement in leg strength, so 2 nurses helped her to the bathroom; she needed a full 2 person assist, and she ?shuffled? her feet when ambulating. Pt was able to wash hands on her own, however tremors were very noticeable. Walked pt back to the cot, and she laid down. Pt?s heartrate remained about 80bpm during the event; EMS was called, and her O2 sat was WDL, and her BP was elevated around 160 diastolic; Pt agreed to be seen in the local emergency room; On 9/24/21, I called the ER and they reported that the pt left before being seen by a provider, however an EKG was performed as intermittent chest pain was noted, and pt was in normal sinus rhythm. I called the pt and she stated that she waited about 4 hours in the ED and wanted to go home because she was too uncomfortable to stay. Today, one day following vaccine, pt stated that she is ?feeling better?, but still ?weak?. She stated that around bedtime last night, she felt ?itchy? and ?prickly? all over her body, and took a Benadryl, which she stated gave her some relief; She stated that both her hands did swell when she noticed that she had trouble removing a ring from them. Overnight she experienced fever-ish symptoms of chills and sweats, and is altering Tylenol and Motrin, which have given her relief. She stated she is walking on her own without assist today, but still feels ?weak? and ?neuropathy-like? feeling in the legs and hands, and overall fatigue noted. She stated that the photophobia and headache continues. She stated occasional chest pain with movement is continuing as well. Pt is in contact with her doctor and is looking for follow-up appointments with them. Pt is aware VAERS report is being done for her.


VAERS ID: 1731834 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-08-04
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Diarrhoea, Dyspnoea, Fatigue, Laboratory test, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: GERD, glaucoma.
Allergies: NKA
Diagnostic Lab Data: Covid test, lab work, cxr.
CDC Split Type:

Write-up: Pt came to ER c/o SOB, fatigue, diarrhea, fever. Onset 10 days.


VAERS ID: 1731879 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-23
Onset:2021-09-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

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

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

Write-up: SYNCOPE 7 MINUTES POST INJECTION AND EMESIS IN THE PARKING LOT 30 MINUTES LATER


VAERS ID: 1731880 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-03-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Shoulder injury related to vaccine administration
SMQs:

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

Write-up: administration error, developed serva


VAERS ID: 1732305 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-23
Onset:2021-09-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness:
Preexisting Conditions: STEVEN JOHNSONS SYNDROME
Allergies: SULFA
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: PATIENT HAS SJS. DEVELOPED RASH ON THE ARM OF VACCINE 2 HOURS AFTER GETTING THE JANSSEN VACCINE. PATIENT TOOK BENADRYL AND WENT TO THE ER ACROSS THE STREET FROM HER HOUSE AND IS HER PLACE OF WOR. SHE WAS DISCHARGED AND NOTIFIED US. THE DOCTOR PRESCRIBED STEROIDS. PT CALLED AT 09/23 4:36PM


VAERS ID: 1732360 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fibrin D dimer, Headache, Inflammation, Menstruation irregular, Muscle spasms, Pain, Pregnancy test negative, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Vestibular disorders (narrow), Fertility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ParaGard IUD (non-hormonal)
Current Illness: cold symptoms earlier in the month
Preexisting Conditions: none
Allergies: dairy
Diagnostic Lab Data: D-dimer on 8/28/21 came back as unlikely for blood clots but showed inflammation Home Pregnancy Test on 9/20/21 showed negative
CDC Split Type:

Write-up: 8/19/21-8/22/21Headache, fever, chills, body aches, vertigo 8/28/21-8/30/21 Leg muscle Spasms, inflammation 9/9/21-9/24/2021 Missed Period (14 days late and counting) my cycle is usually regular I track it on an app..


VAERS ID: 1732361 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-08
Onset:2021-03-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Musculoskeletal stiffness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote, atorvastatin, krill oil
Current Illness: None
Preexisting Conditions: Brain injury, schizo affective, PTSD, depression sometimes
Allergies: Milk allergy, gluten sensitivity
Diagnostic Lab Data: I haven''t done any. I didn''t know how to report it
CDC Split Type:

Write-up: Fatigue, all over muscle stiffness and soreness. Before the shot I jogged and walked 7 miles. Now i can''t even go a block. Or 1/4 of a block.


VAERS ID: 1732420 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest discomfort, Chills, Cough, Dizziness, Dyspnoea, Feeling abnormal, Feeling of body temperature change, Haematemesis, Heart rate irregular, Muscle fatigue, Myalgia, Oxygen saturation decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 15 Sep 2021 ER visit. No issues found at the time but referred to Cardiology (7 October 2021)
CDC Split Type:

Write-up: Hypoxia like symptoms (internal chills under skin, and brain fog) within 5 minutes of getting the vacccine. Pressure around heart, fluttering/ irregular heart beat feeling. Headaches, muscle aches that lead to muscle fatigue/failure. Hot/ cold spells, dizziness. O2 levels (measured with pulse ox) dropped to 86 and remained between 86 and 89 for approximately 10 minutes. Vomiting with bright red blood. Tightness in chest with couching spells and labored breathing. Visited ER on 15 Sep with nothing noted and follow up with cardio.


VAERS ID: 1732622 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-24
Onset:2021-09-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Heart rate increased, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Dehydration (broad)

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

Write-up: After IM administration in the left deltoid, Pt exhibited a racing pulse. We attempted several times to capture an accurate blood pressure reading; the reading was in error a few times, but we also got a readings of 232/127, 185/131, 169/112,71/55, 180/110, and 179/93, BP was clearly elevated. Pt was also nauseated. 25mg diphenhydramine was administered. 911 wasn''t called per Pt request as she was awake and aware and could breathe properly. She contacted her sister to pick her up to go to the hospital. Pt was mobile and was taken to the hospital for evaluation by her sister.


VAERS ID: 1733190 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Chronic inflammatory demyelinating polyradiculoneuropathy, Neuropathy peripheral, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hearing impairment (broad), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Started experiencing tingling April 21st. Bell''s Palsy April 29th. Started to see peripheral neuropathy over next couple months. Diagnosed CIDP in August


VAERS ID: 1733191 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Condition aggravated, Fatigue, Impaired work ability, Migraine, Migraine with aura, Nausea, Neck pain, Pain, Sensitisation
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Arthritis (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: Mirena. Advil occasionally.
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 17 days after my vaccine, I started experiencing migraines typical of those I experience several times a year. I have experienced these headaches most of my life at a rate of several (maybe up to 5 times a year to guess). I ended up with severe neck pain for several days which then turned into the first migraine of the week. I ended up suffering through nine migraines within one week. I?ve never experienced a cluster of migraines to that severity and quantity. Nothing else in my diet, lifestyle, or medications changed with the exception of the Janssen vaccine. When a migraine starts, I lose vision function (aura) and experience severe pain, nausea, fatigue, and sensitivity with migraines and missed a lot of work due to having nine within a week, plus several weeks to feel back to ?normal.? With these migraines, I experienced vision loss, nausea, severe pain and fatigue. I had several phone calls with my neurologist, and was started on prednisone to try to snap the headache streak. When that didn?t work, I went to urgent care and received injections of toradol for the headache pain and finergan for nausea.


VAERS ID: 1733565 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-09-17
Onset:2021-09-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypersensitivity, Mouth swelling, Rash, Swelling, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: allergic reaction/rash/hives Pt. reports had johnson and johnson shot wed. 9/17/21. Now has hives and swelling to mouth, face and all over his body. Large hives/welts on buttocks.


VAERS ID: 1733805 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Dysuria, Faecal elastase test, Fibrin D dimer, Full blood count, Lipase, Metabolic function test, Muscle tightness, Muscular weakness, Myalgia, Nervous system disorder, Pain in extremity, Protein total, Stool analysis, Thyroid function test, Ultrasound Doppler, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: INVOKANA [CANAGLIFLOZIN]; LIPITOR
Current Illness: Abstains from alcohol; Alcohol allergy (Causes shortness of breath); Non-smoker; Type II diabetes mellitus; Weakness
Preexisting Conditions: Comments: The patient did not have history of drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210421; Test Name: Duplex ultrasound; Result Unstructured Data: did not had any significant results.; Test Date: 20210802; Test Name: Urinalysis; Result Unstructured Data: normal; Test Date: 20210903; Test Name: Fibrin D dimer; Result Unstructured Data: positive; Test Date: 20210903; Test Name: Plasma protein; Result Unstructured Data: normal; Test Date: 20210903; Test Name: Thyroid function test; Result Unstructured Data: normal; Test Date: 20210903; Test Name: Lipase; Result Unstructured Data: normal; Test Date: 20210903; Test Name: Fecal elastase test; Result Unstructured Data: normal; Test Date: 20210903; Test Name: Complete blood count; Result Unstructured Data: normal; Test Date: 20210903; Test Name: Stool analysis; Result Unstructured Data: normal; Test Date: 20210903; Test Name: Comprehensive metabolic panel; Result Unstructured Data: normal
CDC Split Type: USJNJFOC20210939353

Write-up: ABDOMINAL PAIN; POSSIBLE NEUROLOGICAL PROBLEM; WEAKNESS/WEAKNESS IN GIRDLE MAGNIFIED; MUSCULAR WEAKNESS; DIARRHEA; MUSCLE FELT ACHEY; LOWER LEG PAIN; MUSCLE FELT LIKE THEY NEED TO BE STRETCHED; PAINFUL URINATION; This spontaneous report received from a patient concerned a 55 year old male. The patient''s weight was 180 pounds, and height was 68 inches. The patient''s concurrent conditions included: type 2 diabetes, non smoker, no alcohol use, alcohol allergy, and weakness in girdle, and other pre-existing medical conditions included: The patient did not have history of drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. Concomitant medications included atorvastatin calcium, and canagliflozin. On APR-2021, the patient experienced muscle felt like they need to be stretched. On APR-2021, the patient experienced lower leg pain. On APR-2021, the patient experienced muscle felt achey. On 10-APR-2021, the patient experienced diarrhea. On 16-APR-2021, the patient experienced muscular weakness. On 21-APR-2021, Laboratory data included: Duplex ultrasound (NR: not provided) did not had any significant results. On 02-AUG-2021, Laboratory data included: Urinalysis (NR: not provided) normal. On 02-AUG-2021, the patient experienced painful urination. On 03-SEP-2021, Laboratory data included: Complete blood count (NR: not provided) normal, Comprehensive metabolic panel (NR: not provided) normal, Fecal elastase test (NR: not provided) normal, Fibrin D dimer (NR: not provided) positive, Lipase (NR: not provided) normal, Plasma protein (NR: not provided) normal, Stool analysis (NR: not provided) normal, and Thyroid function test (NR: not provided) normal. On an unspecified date, the patient experienced abdominal pain, painful urination, possible neurological problem, and weakness/weakness in girdle magnified. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from diarrhea, and muscular weakness, and the outcome of abdominal pain, weakness/weakness in girdle magnified, muscle felt achey, muscle felt like they need to be stretched, lower leg pain, painful urination and possible neurological problem was not reported. This report was non-serious.


VAERS ID: 1733807 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Computerised tomogram, Electrocardiogram, Heart rate, Hypoaesthesia, Peripheral swelling, Pulmonary thrombosis, SARS-CoV-2 test, Thrombosis, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Peanut allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210428; Test Name: COVID-19 virus test; Result Unstructured Data: Not reported; Test Date: 20210428; Test Name: Blood pressure; Result Unstructured Data: Not reported; Test Date: 20210428; Test Name: Pulse rate; Result Unstructured Data: Not reported; Test Date: 20210428; Test Name: Electrocardiogram; Result Unstructured Data: not reported; Test Date: 20210428; Test Name: Sonogram; Result Unstructured Data: Blood clots in lungs and leg; Test Date: 20210428; Test Name: CT scan; Result Unstructured Data: Blood clots in lungs and leg; Test Date: 20210429; Test Name: Sonogram; Result Unstructured Data: Blood clots in lungs.
CDC Split Type: USJNJFOC20210940112

Write-up: SWOLLEN HANDS AND FINGERS; NUMBNESS IN LEGS AND FEET; BLOOD CLOT IN LUNG; BLOOD CLOT IN LEG; This spontaneous report received from a patient concerned a patient of unspecified age and sex of unknown race and ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: peanut allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: Unknown, expiry date: Unknown) dose was not reported,1 total, administered on 09-APR-2021 13:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 09-APR-2021 patient got covid-19 vaccine. Patient wanted to get the Moderna vaccine but they told that patient had a peanut allergy so patient could not get the Moderna or the pfizer vaccine and could only get the janssen shot. After vaccination patient went home and fell asleep for 6 hours. Things were OK for 7 days, patient was drinking a lot of water and thought that it was the reason for the swelling. Then 2 days later on 18-APR-2021, not only there was swelling but feet and legs felt numb. Patient did not know what was wrong, since the only thing patient heard about the Janssen shot was that only women were getting the blood clots not men. Two weeks after the vaccination on 23-APR-2021 patient experience swollen hands and fingers. After hearing the news the next day on 28-APR-2021 patient went to the Emergency room to see what was wrong. When patient got there and was given a Covid-19 test and entered the hospital. patient sat for 2 hours waiting before they started to check patient. Then they checked patients blood pressure, pulse readings, then they put on oxygen and gave an IV. After a little time passed they took patient in for tests. On 28-APR-2021 tests were performed. Laboratory data included: Blood pressure (NR: not provided) Not reported, COVID-19 virus test (NR: not provided) Not reported, CT scan (NR: not provided) Blood clots in lungs and leg, Electrocardiogram (NR: not provided) not reported, Pulse rate (NR: not provided) Not reported, and Sonogram (NR: not provided) Blood clots in lungs and leg. They registered to stay the night for more tests. On 28-APR-2021 patient was hospitalized and stayed the night and they gave medicine and more tests. On 29-APR-2021 another sonogram was done to check the clots and only found them in his lungs. They prescribed blood thinners to take (Eliquis) for 3 months and sent home. On 20-Sep-2021, day of reporting patient still on treatment medication eliquis. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from numbness in legs and feet, blood clot in lung, and swollen hands and fingers, and the outcome of blood clot in leg was not reported. This report was serious (Hospitalization Caused / Prolonged). This case, from the same reporter is linked to 20210602521.; Sender''s Comments: V0: 20210940112-COVID-19 VACCINE AD26.COV2.S -blood clot in lung, blood clot in leg, swollen hands and fingers. These events are considered unassessable. The events have a compatible/suggestive temporal relationship, are unlabeled, and have unknown scientific plausibility. There is no information on any other factors potentially associated with the events. 20210940112-COVID-19 VACCINE AD26.COV2.S -numbness in legs and feet. This event is labeled per RA and is therefore considered potentially related.


VAERS ID: 1733814 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-09-22
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Chills, Heart rate, Hypertension, Overdose, Oxygen saturation, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Hypertension (narrow), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Sulfonamide allergy
Preexisting Conditions: Comments: The patient had no health conditions.
Allergies:
Diagnostic Lab Data: Test Date: 20210922; Test Name: Blood pressure; Result Unstructured Data: 190/70 mmHg; Test Date: 20210922; Test Name: Oxygen saturation; Result Unstructured Data: 98 %; Test Date: 20210922; Test Name: Heart rate; Result Unstructured Data: 83 bpm
CDC Split Type: USJNJFOC20210943963

Write-up: ELEVATED BLOOD PRESSURE; RECEIVED AN ENTIRE VIAL OF THE JANSSEN COVID 19 VACCINE INSTEAD OF ONLY ONE DOSE; CHILLS; LOW GRADE FEVER; This spontaneous report received from a health care professional concerned a 36 year. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: sulfa allergy, non-smoker, and non-alcohol user, and the patient had no health conditions. The patient experienced drug allergy when treated with cefalexin for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 212A21A expiry: 21-DEC-2021) dose was not reported, 1 total administered to right arm on 22-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-SEP-2021, the patient was accidently given an entire vial of the Janssen COVID-19 Vaccine instead of only one dose at the vaccination facility (overdose). The patient had not experienced any side effects at the time of reporting. On the same day, the patient had visited Emergency Department (ER) and her vitals were monitored at ER. Her blood pressure was found to be 190/70 mmHg (elevated blood pressure), Heart rate was 83 bpm (beats per minute), and Oxygen saturation was 98%. The Patient was discharged from the Emergency Department on the same day and experienced a low grade fever (no Temperature recorded) and chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from elevated blood pressure, and the outcome of received an entire vial of the janssen covid 19 vaccine instead of only one dose, low grade fever and chills was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint: 90000194469. Initial information was processed with additional information received on 23-SEP-2021.The following information was updated and incorporated into the case narrative: Reporter(Pharmacist) added as contact, events(low grade fever, chills) were added, labelling, causality and narrative were updated.; Sender''s Comments: 20210943963-COVID-19 VACCINE AD26.COV2.S-elevated blood pressure. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1733824 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Drug eruption, Fear, Laboratory test, Mass, Ultrasound scan
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood cholesterol increased; Blood pressure; Gastrooesophageal reflux disease
Preexisting Conditions: Medical History/Concurrent Conditions: Steroid therapy (Consumer mentioned having had steroid shots to treat symptoms but doctors wouldn''t give him more due to duration of symptoms.); Surgery; Comments: Patient was taking blood pressure medications and statins.
Allergies:
Diagnostic Lab Data: Test Date: 20210922; Test Name: Diagnostic ultrasound; Result Unstructured Data: not provided; Comments: doctor took ultrasound of legs to make sure there''s no blood clots; Test Name: Lab test; Result Unstructured Data: diagnosis: drug eruption
CDC Split Type: USJNJFOC20210945388

Write-up: DRUG ERUPTION (GENERALIZED ITCHINESS ALL OVER BODY WHICH INTENSIFIED, RASH ALL OVER BODY, LEGS, STOMACH, BACK, AND THEN ALL TORSO); LUMP ON RIGHT ARM (FEEL LIKE A KNOT IN MUSCLE); GOT SCARED; This spontaneous report received from a patient concerned a 68 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: several surgeries, and steroid shots, and concurrent conditions included: slightly elevated cholesterol, acid reflux, and blood pressure, and other pre-existing medical conditions included: Patient was taking blood pressure medications and statins. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, and expiry: UNKNOWN) dose was not reported, administered on 17-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the patient experienced drug eruption (generalized itchiness all over body which intensified, rash all over body, legs, stomach, back, and then all torso). On MAR-2021, the patient experienced lump on right arm (feel like a knot in muscle). On MAR-2021, the patient experienced got scared. On 22-SEP-2021, Laboratory data included: Diagnostic ultrasound (NR: not provided) not provided. Laboratory data (dates unspecified) included: Lab test (NR: not provided) diagnosis: drug eruption. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from lump on right arm (feel like a knot in muscle), had not recovered from drug eruption (generalized itchiness all over body which intensified, rash all over body, legs, stomach, back, and then all torso), and the outcome of got scared was not reported. This report was non-serious.


VAERS ID: 1733855 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram, Magnetic resonance imaging
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: EKG; Result Unstructured Data: Not Reported; Test Name: MRI; Result Unstructured Data: Not Reported
CDC Split Type: USJNJFOC20210947808

Write-up: CHEST PAIN; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient experienced chest pain. Laboratory data (dates unspecified) included: EKG (NR: not provided) Not Reported, and MRI (NR: not provided) Not Reported. The action taken with covid-19 vaccine was not applicable. The outcome of chest pain was not reported. This report was non-serious.


VAERS ID: 1734768 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-13
Onset:2021-09-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cardiac discomfort, Chest X-ray, Electrocardiogram, Headache, Injection site pain, Pain in extremity, Pulmonary congestion
SMQs:, Cardiac failure (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (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: HCTZ/Lisionipril 12.5/10 mg Loraratadine 10 mg Azelastine/fluticazole 137/50 mcg x4 per day 81 mg baby aspirin DR One-a-day multivitamin gummy Fish oil Vitamin D (2000 iu)
Current Illness: Mild cold/seasonal allergies
Preexisting Conditions: Hypertension managed with medication
Allergies: Latex
Diagnostic Lab Data: 12-point ekg Chest x-ray Blood work All on 22 SEP 2021
CDC Split Type:

Write-up: Chest congestion and severe discomfort in heart Soreness down left arm from injection site to fingers Headache


VAERS ID: 1734974 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-21
Onset:2021-09-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Electrocardiogram, Fibrin D dimer, Full blood count, Lip oedema, Metabolic function test, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Latanoprost 0.005% eye drops Carvedilol Pravastatin Tamsulosin Losartan potassium Vitamin C Zinc Vitamin D3 Fish oil Baby aspirin
Current Illness: Cardiac stent 8/21
Preexisting Conditions: Hypertension Bladder CA s/p chemo Arthritis Central retinal vein occlusion w/ macular edema right eye
Allergies: None known
Diagnostic Lab Data: CBC Ddimer BMP Troponin EKG CXR
CDC Split Type:

Write-up: Angioedema of the upper lip and hands bilaterally


VAERS ID: 1734976 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-08-06
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blindness unilateral, Cataract, Retinal detachment
SMQs:, Accidents and injuries (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (narrow), Retinal disorders (narrow)

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

Write-up: Woke up blind in left eye on August 6th, 2021. Diagnosed with a massive cataract. Had cataract surgery on August 24th 2021, which led to a detached retina on September 3rd. Vitrectomy on September 10th. Diagnosed with subfoveal prefluroroncarbon fluid on September 21st.


VAERS ID: 1735149 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-22
Onset:2021-09-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Dehydration, Diarrhoea, Fatigue, Headache, Menstruation irregular, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad), Noninfectious diarrhoea (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: 9/24/21 went to Medhero for dehydration. Received a medicated IV for headache, nausea, and hydration.
CDC Split Type:

Write-up: Piercing debilitating headache, body aches, severe chills, vomiting (couldn?t even keep down water), nausea, diarrhea, severe exhaustion, abdominal pain, and I got my period one week after having it!!!!!!


VAERS ID: 1735225 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-09-22
Onset:2021-09-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Headache, Pharyngeal swelling, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Two different Flu vaccines, 5-10 years ago
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Eggs, shellfish, cats, dogs, flu shot/vaccine, nickel
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately started to feel throat swelling, headache, eyes swelling and had to use 2 epi pens five min apart to get the symptoms to reside. Then a few hours later face, and throat swelling returned along with headache and went to ER for treatment with IV steroids


VAERS ID: 1735423 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-08-25
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adverse reaction, Anticoagulant therapy, Computerised tomogram pelvis, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Magnetic resonance imaging, Pain in extremity, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (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), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: benicar, norvasc, metoprolol
Current Illness: n/a
Preexisting Conditions: high blood pressure
Allergies: n/a
Diagnostic Lab Data: Ct scan of lungs and pelvis RLE ultrasound MRI of right leg
CDC Split Type:

Write-up: adverse reaction-Right leg DVT and bilateral pulmonary emboli. Symptoms- right leg pain and shortness of breath Time- over 3 weeks Treatment- anticoagulant Outcome- dischrged from hospital. Still on medications for 6 months to a year


VAERS ID: 1735482 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autoimmune disorder, Guillain-Barre syndrome, Neurological symptom
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Systemic: Autoimmune Disease (diagnosed by MD)-Severe, Systemic: Neurological Disorder (diagnosed by MD)-Severe, Additional Details: Guillan Barre


VAERS ID: 1735531 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-26
Onset:2021-09-22
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKS
Diagnostic Lab Data: N/A going to clinic today
CDC Split Type:

Write-up: Formation of Rash bilateral upper and lower extremities. Red itchy, present for 4 days and getting worse. My son who does not live with me also had similar reaction of red raised itchy bumps all over upper extremities after a few weeks after receiving the Janssen Vacine.


VAERS ID: 1735555 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-21
Onset:2021-09-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Blood clot?left calf


VAERS ID: 1735626 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-23
Onset:2021-09-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Adverse event, Blood test, Computerised tomogram, Incoherent, Migraine, Scan with contrast, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: CAT scan (including one with contrast), full blood work
CDC Split Type:

Write-up: Adverse events: severe migraine, convulsion, incoherent speech Treatment: Ambulance, paramedics, had to stabilize in order to be taken to ER


VAERS ID: 1735675 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-15
Onset:2021-09-13
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Dyspnoea, Fatigue, Malaise, SARS-CoV-2 test positive, Seizure like phenomena
SMQs:, Anaphylactic reaction (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: HISTORY OF MARFAN SYNDROME, AORTIC VALVE REPLACEMENT, tavr, HTN, HYPERLIPDEMIA, VENT TACHYCARDIA.
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: 9/13/21 COVID-19 SARSAgFIA = DETECTED
CDC Split Type:

Write-up: 9/14/21 SEEN IN ER AT MEDICAL CENTER WITH EIZURE LIKE ACTIVITY. MOVED TO CURRENT ADDRESS A FEW WEEKS AGO AND SINC ETHAT TIME REPORTED WEAKNESS, FATIGUE, DYSPNEA, MALAISE. ADMITTED TO INPATIENT STATUS . ON 9/20/21 DISCHARGED HOME TO FOLLOW UP WITH CARDIOLOGY.


VAERS ID: 1735726 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-26
Onset:2021-08-24
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norco Lisinopril Tramadol
Current Illness: None
Preexisting Conditions: Post laminectomy L2-3 on Aug 20th 2021
Allergies: None
Diagnostic Lab Data: Ultrasound,CTA and emergency surgery
CDC Split Type:

Write-up: DVT and multiple pulmonary embolisms


VAERS ID: 1735738 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

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

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

Write-up: Patient had vasovagal reaction. Fainted. Was able to communicate and give his mom''s phone number. Nurse, pharmacist and customer physician tended to the patient. He was still faint after 10 minutes so 911 was called and the squad took over patient care at that time.


VAERS ID: 1735739 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-30
Onset:2021-08-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Acute myocardial infarction, Allergy to vaccine, Differential white blood cell count, Dizziness, Electrocardiogram abnormal, Full blood count, Hyperhidrosis, Metabolic function test, Seizure like phenomena, Syncope, Troponin I
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Triamcinolone Acetonide (TRIDERM) 0.5 % Top Cream
Current Illness: Atopic Dermatitis
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA. 0900: patient reports dizziness 0903: BP 97/58, HR- 44, 02 RA 99%. syncopal episode occur. S/SX seizure/posture (15 seconds), diaphoretic. DOD aware, paramedics called 0905: AxOx4. BP 98/60, HR 60, O2 98% 0905: medics arrive to vaccine clinic. EKG done + STEMI. Patient transferred via gurney to ambulance for higher level of care, Allergy to COVID-19 vaccine documented in Allergies activity, Patient advised to discuss second dose considerations with a clinician Patient transferred via ambulance to ER 0940: patient arrival at ER. BMP, CBC w/auto Diff, Troponin I, ED EKG-CernerCV, Diagnosis: Syncope, Patient advised to follow up with primary care physician within 1-2 days


VAERS ID: 1735791 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-15
Onset:2020-12-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN VAC31518COV1001 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Infection, Laboratory test, Loss of personal independence in daily activities, Scar, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Dementia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Sulfa
Diagnostic Lab Data: I went to the hospital for tests and we know what it isn''t..i tried to go 2 more times but each time the hospital was 2 packed wirh cobid patients. The first time was stupid, they didnt even look at it, just wrote me a topical script and thats ut. It didn''t work at all.
CDC Split Type:

Write-up: It was like my skin fell off 3 times. It started as pinpoints on my legs then in a week spread to my face where my skin geew and fell off 3 times over. I had active infections on my face from December until end of May. The nurse took 2 hours of notes about this all in june 2021. I''m scarred for life on my face besides the fact i couldn''t leave the house for 5 months


VAERS ID: 1735805 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blindness, Blood pressure increased, Blood test normal, Dizziness, Heart rate increased, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood tests show no abnormalities. Blood pressure is normal in all situations except when standing at which time spikes in blood pressure and heart rate are recorded. Dr. recommendations were to hydrate additionally which has not changed any of the side effects which are still ongoing 6 months later.
CDC Split Type:

Write-up: Ongoing dizziness and elevated heart rate when standing up. Multiple episodes of losing vision during light headlines. Near miss with multiple episodes of loss of consciousness.


VAERS ID: 1735964 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-02
Onset:2021-09-06
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: Shingles, neck being left ear and left shoulder, 2+ weeks


VAERS ID: 1736662 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Computerised tomogram head normal, Dizziness, Dysstasia, Gait inability, Magnetic resonance imaging head normal, Mobility decreased, Somnolence, Urinary tract infection
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D, E, B-12, B-6, Co-Q10, Multi Vitamin, baby aspirin,
Current Illness: none
Preexisting Conditions: Heart Disease, COPD, Diabetes, Small Cell Lung Cancer (in remission)
Allergies: Penicillian
Diagnostic Lab Data:
CDC Split Type:

Write-up: LIGHT HEADED, DIZZY, COULDN''T STAND BY HERSELF, SLEPT A LOT DURING THE DAY COULDN''T TELL WHEN SHE HAD TO GO TO THE BATHROOM, COULDN''T GET OUT OF BED BY HERSELF, SOMEONE HAD TO STAY WITH HER AROUND THE CLOCK, SHE GOT A UTI IN AUGUST 2021 PUT HER IN HOSPITAL FOR 2 WEEKS AND NOW IN A NURSING HOME FOR 2 WEEKS AND SHE STILL CAN''T WALK OR STAND WITHOUT ASSISTANCE. HER SHORT TERM MEMORY STARTED THE NEXT DAY AFTER THE SHOT, AND IT STILL HASN''T RETURNED, EVEN AFTER 4 MONTHS, SEVERAL CT SCANS MRI SCANS DURING THAT 4 MONTHS AND NOTHING THAT WOULD EVEN THINK SHE HAS ANYTHING WRONG WITH BRAIN. SHE DOESN''T EVEN KNOW HOW TO ANSWER THE PHONE NOW.


VAERS ID: 1736740 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anal incontinence, Asthenia, Back pain, Dizziness, Dysphagia, Dyspnoea, Gait disturbance, Guillain-Barre syndrome, Hypoaesthesia, Hypoaesthesia oral, Laboratory test, Mastication disorder, Mobility decreased, Nausea, Neck pain, Pain, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Demyelination (narrow), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations: Pfizer : adverse reactions reported
Other Medications: None
Current Illness: None
Preexisting Conditions: Heart Disease
Allergies: Various
Diagnostic Lab Data: Various
CDC Split Type:

Write-up: 20 minutes after the vaccination begin having neck and back pains on the right side of the body. Pens and needles feeling through out body, weakness, dizzy, nausea, unsteady walking, face and tongue mouth went numb, Difficulty chewing and swallowing. Shooting pain throughout of body, lost the control of bowel. Catheter has been inserted. Unable to walk long distances, difficulty breathing. Was diagnosed with Gullain-barre syndrome.


VAERS ID: 1736808 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-07
Onset:2021-09-21
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19 pneumonia, Condition aggravated, Haematuria, Hypotension, Intensive care, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, apixaban, atorvastatin, digoxin, furosemide, gabapentin, metoprolol, pantoprazole, potassium, tamsulosin, finasteride, budesonide/formoterol
Current Illness: Discharged from the hospital 3/17/2021 for CHF exacerbation (admitted 2/23), asymptomatic hypotension with atrial fibrillation 4/15/2021, and gross hematuria 5/3/2021
Preexisting Conditions: CAD, CHF, ICM, AF, COPD, BPH, OA, obesity
Allergies: NKDA
Diagnostic Lab Data: 09/21/2021@15:03:34 COVID-19 DETECTED
CDC Split Type:

Write-up: Patient admitted to ICU for COVID-19 pneumonia on 9/21 due to high oxygen requirements. Still admitted to the ICU at the time of this submission.


VAERS ID: 1736843 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-26
Onset:2021-08-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram, Fatigue, Hypertension, Laboratory test, Pain, Pyrexia, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Urgent care visit- Xray 9/8/2021 Emergency room visit-EKG, labwork, X-ray 9/14/2021
CDC Split Type:

Write-up: Fever over 101 for 17 consecutive days, shortness of breath ongoing 30 post vaccine, body aches ongoing 30 post vaccine, fatigue ongoing 30 days post vaccine, hypertension with no history post vaccine ongoing.


VAERS ID: 1736863 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
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:
CDC Split Type:

Write-up: Diagnosed Blood Clots 10-11 days after receiving vaccine.


VAERS ID: 1736894 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Chest X-ray abnormal, Chest pain, Condition aggravated, Deep vein thrombosis, Inflammation, Pain in extremity, Pulmonary embolism, Ultrasound chest
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pneumonia- severe chest pain and near fainting Influenza-severe chest pain and flushing
Other Medications: Tizanidine 4mg Oxycodone Hydrochlor 30mg Vitamin D3 Vitamin C B12 injection Azelastine
Current Illness: Chronic pain Degenerative disc disease Osteoarthritis Hx. Deep Vein Thrombosis Hx. Peripheral Vascular Disease Polyneuropathy
Preexisting Conditions: Chronic pain Degenerative disc disease Osteoarthritis Hx. Deep Vein Thrombosis Hx. Peripheral Vascular Disease Polyneuropathy
Allergies: Aspirin Zofran Dilaudid Pneumonia vaccine Influenza vaccine Lortab (Blue dye) -Mycin antibiotics
Diagnostic Lab Data: Blood work and ultrasounds on legs and chest
CDC Split Type:

Write-up: Received vaccine on Aug. 2. First noticed right lower chest pain two days later. Went to Urgent Care for worsening pain evaluated with chest XRAY and told it was inflammation, sent home with antibiotics. No improvement in symptom, worsening pain over time. Started having leg pain last week 9/21/2021. Went to emergency room that day, was diagnosed with deep vein thrombosis and pulmonary embolism. Started on blood thinners but not admitted.


VAERS ID: 1737013 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-03-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood potassium decreased, Blood test abnormal, Chills, Computerised tomogram head, Computerised tomogram neck, Condition aggravated, Feeding disorder, Head discomfort, Headache, Insomnia, Loss of personal independence in daily activities, Magnetic resonance imaging normal, Malaise, Mobility decreased, Neurological examination, Pain, Platelet count increased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow)

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: multivitamin and fish oil
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: bananas
Diagnostic Lab Data: ER - 5/11/2021 ER - 5/12/2021 - CT Scan of head and neck with contrast (normal results) and ran blood panel - all normal except slightly elevated platelet count and slightly low potassium MRI 5/17/2021 - normal results
CDC Split Type:

Write-up: Got vaccine and that night had worst headache of my life along with fever, chills, and general feeling of being sick. Took OTC pain reliever and woke up feeling slightly better the next morning. Over the next few weeks, I kept getting headaches, which is very out of the norm for me, as I hardly ever have them. OTC pain meds didn''t help but they would come and go. Headaches began coming with much more frequency and intensity. Went and saw my PCP on 5/7/2021. She was concerned by the length of the headache without relief (it had been almost 1.5 weeks of a severe headache with no relief at this point, so she called in for me to have MRI). Pain intensified and become constant and excruciating. Ended up in the ER two times on 5/11 and 5/12. Pain was so severe I couldn''t function, sleep, or eat. It felt like my head was going to explode and was WAY worse than natural childbirth, which I have gone through 3 times. Had CT Scan with contrast, normal results. Sent home with strong pain meds and gave referral to neurologist. Saw 2 neurologists they have high dose pain meds for me to take. These did help the headache slightly better but gave me stomach issues. Had MRI on 5/17, with normal results. Over the next month relied on family to help my family survive, as I mostly laid in bed. Finally began to feel better and was able to slowly wean off strong meds. Now I have sporadic headaches which are still out of the norm for me but not as intense as the May ones.


VAERS ID: 1737170 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Heart rate increased, Hypotonia, Lethargy, Pulse abnormal, Seizure, Tremor, Unresponsive to stimuli
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient arrived to COVID vaccine clinic around 9 am on 9/27. She was very nervous to get her shot and verbalized this to other patients while waiting in line. About 15 minutes into her 30-minute observation (allergic to Penicillin and bee venom) a staff member was grabbing an emesis bag for the patient, so I went to assess her. As I approached, the patient slumped over onto the desk and became unresponsive. Patient began shaking all over. I lowered her to the ground and held her head for the duration of the seizure for safety. Another patient came over stating she is a nurse and checked the patient?s pulse, stating it was very fast and weak. Patient was unresponsive and shaking for 1-2 minutes. When the shaking ended, she opened her eyes and was able to ask where she was. After another minute or so, we assisted patient onto the gurney and patient was able to help by using her legs to push up from the floor. We took patient to the ED for evaluation. Patient remained lethargic but was responsive to voice while en route to the ED


VAERS ID: 1737222 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-05
Onset:2021-09-24
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood immunoglobulin G, Blood test abnormal, Brain scan normal, Coagulation time, Differential white blood cell count, Full blood count, Increased tendency to bruise, Laboratory test normal, Petechiae, Platelet count decreased, Platelet transfusion
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Started Aleve 2 months ago, calcium supplements and multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Brain scan, multiple blood draws for cancer, CBC, with differential , clotting time.
CDC Split Type:

Write-up: I started having spontaneous bruising and petechiae on my entire body. When the bruises got bigger I went to the ER. I had no other symptoms, felt just completely normal. They did labs and found that I had almost 0 platelets in my blood: 2000! The Immediately admitted me, took me for brain scan, did more labs looking for disease. Both came back normal that first day on Saturday, 9/25. They scheduled me for platelet infusion, steroids, and IgG that evening. Another blood draw and had only raised to 4000. So more platelet infusion, steroids, Sunday went up to 40,000. Next draw showed dropped back to 29,000. More steroids sunday night, with Blood draw this morning , Platelets up to 35,000. Dr?s are perplexed as to this sudden drop in platelets to so drastically low . I still feel perfectly fine, NO other symptoms except the excessive bruising/petechiae. I felt this should be reported because this has been shown to be an after effect of several of the vaccinations


VAERS ID: 1737297 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye movement disorder, Immediate post-injection reaction, Loss of consciousness, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient became unconscious roughly 10 seconds after vaccine was administered. Was shaking and eyes rolled to back of head. Unresponsive for about 20 seconds. 911 was called immediately and paramedics arrived and transported patient to hospital.


VAERS ID: 1737338 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-22
Onset:2021-09-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None disclosed
Preexisting Conditions: None disclosed
Allergies: No
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient had returned to work post vaccination. Approximately 90 minutes later patient brought to medical at plant and sent out via ambulance.


VAERS ID: 1737391 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Product administered to patient of inappropriate age
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had received injection on 9/25/2021. He was taken to the ER by his father for the complainant of dizziness and lightheadedness.


VAERS ID: 1737426 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-10
Onset:2021-04-02
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, Computerised tomogram abdomen, Computerised tomogram thorax abnormal, Continuous haemodiafiltration, Mental status changes, Metabolic acidosis, Pneumonia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, fluticasone inhaler, ibuprofen
Current Illness: unknown
Preexisting Conditions: asthma, arthritis, hypertension, obesity, CKD
Allergies: NKDA
Diagnostic Lab Data: 04/02/2021: COVID-positive test, CT chest found multifocal pneumonia
CDC Split Type:

Write-up: Patient admitted to hospital for altered mental status, was fully vaccinated for COVID. Course complicated by COVID+ multifocal pneumonia, profound metabolic acidosis, AKI, and a CT A/P , CVVH to HD. Patient was discharged to rehab.


VAERS ID: 1737476 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203AZIA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Colitis, Colonoscopy, Computerised tomogram, Condition aggravated, Haematochezia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamins
Current Illness: No illnesses
Preexisting Conditions: Ulcerative Colitis
Allergies: Amoxicillin
Diagnostic Lab Data: CT Scan 9/20/2021 and Colonoscopy 9/24/2021
CDC Split Type:

Write-up: One week later, I started experiencing abdominal cramping. The next week I started seeing blood in my stools. My colon is now inflammated.


VAERS ID: 1737479 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-19
Onset:2021-09-24
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Hypoxia, Productive cough, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized due to dyspnea, hypoxia, fever, productive cough.


VAERS ID: 1737483 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-22
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Disability, Impaired work ability, Speech disorder
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metformin 500 mg ,simvastatin 20 mg , gabapentin 300 mg ,amlodipine 10 mg ,aspirin 325 mg
Current Illness: high blood pressure,diebeted,
Preexisting Conditions: high blood pressure,diebeted,
Allergies: none
Diagnostic Lab Data: 4/22/2021 suffered a stroke, hospitalized on 4/23/2021 for 3 days! affected right side ,speech was affected. been off work since,Still currently off work disabilty 9/27/2021
CDC Split Type:

Write-up: 4/22/2021 suffered a stroke, hospitalized on 4/23/2021 for 3 days! affected right side ,speech was affected. been off work since,Still currently off work disabilty 9/27/2021


VAERS ID: 1737534 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: diarrhea, vomiting, diffuse urticaria


VAERS ID: 1737628 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Chest discomfort, Condition aggravated, Cough, Dizziness, Dyspnoea, Fatigue, Headache, Pain in extremity, Peripheral swelling, Throat clearing
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer Covid 19 vaccine 57 yrs old, 01/13/2021
Other Medications: Topomax, Lexapro, Benedryl
Current Illness: none
Preexisting Conditions: asthma, anxiety, seasonal allergies/hay fever
Allergies: Compazine, Simvastatin, Sulfites, Penicillin,Pfizer Cov 19 vac
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine given, 20 min later chest tightening, cough, breathing difficulty. EPI-Pen administered. Chest still tight, nebulizer treatment. 30 min later ambulance to the Emergency Room. Received IV benedryl, IV steroids. Observation x 2.5 hours then discharged home. Fatigue x 3 weeks and counting. Asthma flare ups daily x 2.5 weeks. Increased need for Albuteral inhaler, now using Alvesco inhaler daily. Sporadic dizzyness upon standing since 09/09/2021 after vaccine. Dull headache. Noticed small area of swelling and pain in lower left leg, no bruise or injury to that area.


VAERS ID: 1737637 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-27
Onset:2021-09-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2069ZIA / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Burning sensation, Chest pain, Chills, Dizziness, Echocardiogram, Electrocardiogram abnormal, Electrocardiogram ambulatory, Fatigue, Fibrin D dimer, Full blood count normal, Heart rate increased, Paraesthesia, Platelet count normal, Troponin, Ultrasound Doppler
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills singulair Ventolin inhaler allegra
Current Illness: none
Preexisting Conditions: asthma environmental allergies
Allergies: none
Diagnostic Lab Data: Lower Extremity venous doppler d-dimer, CBC w platelets, troponin , EKG (was borderline abnormal result)- otherwise all bloodwork was normal Echocardiogram with a cardiologist 4 days after ER visit in addition to more bloodwork which was normal referred then to a cardiologist, just finished wearing a 2 week heart monitor, of which I''m waiting the results from. he advised if the leg burning and tingling persist, to then see a neurologist. symptoms are getting less intense, now as it as been 4 weeks since vaccine
CDC Split Type:

Write-up: After the 36 hours of expected chills, dizziness (no fever), and fatigue resolved, 4 days after vaccine, developed chest pain, burning down right leg, tingling and feeling of rapid heart beat. Being a nurse practitioner myself, and knowing the symptoms of serious things, I did not want to "overreact". I waited a few days for symptoms to resolve, which they didn''t . I then was advised by my primary doctor to go to ER for evaluation.


VAERS ID: 1738061 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-27
Onset:2021-08-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Death, Dyspnoea, Headache, Intensive care, Laboratory test, Malaise, Myalgia, Nausea, Oropharyngeal pain, Oxygen saturation decreased, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-18
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin, Hydrochlorothiazide, Prednisone, Aleve, Cetirizine, Tizanidine
Current Illness: Rheumatoid Arthritis
Preexisting Conditions: Asthma, Obesity, Hypertension
Allergies: Tobacco
Diagnostic Lab Data: Multiple (Check with medical facility).
CDC Split Type:

Write-up: Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting. Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021.


VAERS ID: 1738257 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-27
Onset:2021-08-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Dyspnoea, Laboratory test, Oxygen saturation decreased
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine besylate 5mg hydrochlorothiazide 25mg pravastatin sodium
Current Illness: none
Preexisting Conditions: high blood pressure, prediabetic
Allergies: none
Diagnostic Lab Data: Multiple (contact Medical Center)
CDC Split Type:

Write-up: next morning coughing , was admitted to hospital sept 6 with low oxygen levels, hard to breath, left hospital September 13th.


VAERS ID: 1738596 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-04-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram, Craniocerebral injury, Electroencephalogram, Magnetic resonance imaging, Muscular weakness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Lower extremity weakness, collapsed and had TBI, hospitalized for possible spinal stroke


VAERS ID: 1738597 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypertension, Interchange of vaccine products, Muscle spasms, Palpitations, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Hypertension (narrow), Cardiomyopathy (broad), Medication errors (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer covid vaccine, Age 51, 1 dose only, given on december 18, 2020 same symptoms as this one.
Other Medications: Vitamin B12, Iron, Fish Oil, CoQ10, chondroitin, centrum silver
Current Illness: None
Preexisting Conditions: None
Allergies: Antihistamine (benadryl) , codeine, Pseudoephedrine, chlorhexidine, morphine. Rock Cod fish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart palpitations, Head ache, Muscle spasms, tachycardia (170), high blood pressure


VAERS ID: 1738627 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-04
Onset:2021-09-27
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

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

Write-up: Patient received vaccine on May 4th. She was 9 weeks pregnant. In June she had a miscarriage. September 27 pt is admitted to hospital with PE.


VAERS ID: 1739930 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-07-19
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Blood test abnormal, COVID-19, Cholecystitis, Cholecystitis infective, Colostomy, Feeling cold, Gastrooesophageal reflux disease, Infection, Malaise, Pain, Pyrexia, SARS-CoV-2 test, SARS-CoV-2 test positive, Thrombosis, Vaccination failure, Vomiting
SMQs:, Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: MULTIPLE VITAMINS
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210728; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 20210729; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 20210730; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 20210730; Test Name: Blood test; Result Unstructured Data: Abnormal; Test Date: 20210731; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210857180

Write-up: GALLBLADDER INFECTION (CHOLECYSTITIS); CHOLECYSTITIS INFECTIVE; BLOOD CLOT THATS ON THE TOP OF LIVER (THROMBOSIS); ANTICOAGULANT THERAPY; COVID-19 INFECTION; COLOSTOMY; INFECTION; SARS-COV-2 TEST POSITIVE; SUSPECTED CLINICAL VACCINATION FAILURE; BLOOD TEST ABNORMAL; PAIN; FEELING COLD; MALAISE; VOMITING; PYREXIA; BAD CASE OF ACID REFLUX (GASTROOESOPHAGEAL REFLUX DISEASE); This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAERS) (VAER reference number 1582450) concerned a 63 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient experienced drug allergy when treated with codeine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: UNKNOWN) dose was not reported, 1 total administered to right arm on 03-JUL-2021 at 12:43 PM for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. Concomitant medications included ascorbic acid/ergocalciferol/folic acid/retinol/tocopherol/vitamin. On 19-JUL-2021, the patient woke up at 5:30 am with a bad case of acid reflux which he had a while ago but not since he was taking prebiotics and probiotics which helped but not this time. He was vomiting and had a fever. He took Omeprazole that morning which has relieved it for a while but after eating some food it started all over again. The vomiting and fever was back with higher severity than before. By Wednesday, on 28-JUL-2021, it was better bad so he went over to a Medical Center for COVID-19 test which was was negative. They did ran a battery of blood work on him but after waiting for five long hours to be seen by a doctor he was extremely cold in the waiting area and he was in great pain sitting on the uncomfortable chairs. On 29-Jul-2021, The patient went over to urgent care and once again the PA give him another COVID- 19 test which was negative. The PA suggested the patient to visit over to a Hospital. On 30-Jul-2021, the patient went over there was tested again and was negative again. They checked him in but they never found the Covid-19 after being poked and stuck so many times he was really not feeling good and they did know that he had a inflamed and infected gallbladder which the infection traveled through his blood stream Which was very dangerous for him however it app eared that they were taking his blood every two hours which became very unbearable for him and he wanted to go home I went to pick him up at 3:00 am One of the call me to convince to still in the hospital but he refused. On 31-Jul-2021, the patient went over to another Hospital COVID test where he was found positive. The patient was diagnosed with COVID-19 infection (suspected clinical vaccination failure). All because his gallbladder was very inflamed and infected due to the vaccine and he also has a blood clot that was on top of his liver. The patient had to wear a colonoscopy bag until they can remove his gallbladder which was about four weeks. He had to wear the bag to drain any infection. He also administered with blood thinner (anticoagulant therapy). On an unspecified date, the patient was admitted to hospital. The patient was hospitalized for 7 days. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from anticoagulant therapy, blood test abnormal, covid-19 infection, gallbladder infection (cholecystitis), cholecystitis infective, colostomy, feeling cold, bad case of acid reflux (gastrooesophageal reflux disease), infection, malaise, pain, pyrexia, sars-cov-2 test positive, blood clot thats on the top of liver (thrombosis), and vomiting, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Hospitalization Caused / Prolonged). This report was associated with product quality complaint : 90000191544 The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. A manufacturing related root cause could not be identified. Based on the Regulatory Authority evaluation/investigation performed. Additional information was received from Complaint Vigilance on 23-SEP-2021. The following information was updated and incorporated into the case narrative: product quality complaint investigation results added.; Sender''s Comments: V2: Additional information received updates: Product quality complaint investigation results added. This added information does not alter the causality of prior assessed events. 20210857180- COVID-19 VACCINE AD26.COV2.S-gallbladder infection (cholecystitis), cholecystitis infective, blood clot thats on the top of liver (thrombosis), covid-19 infection, bad case of acid reflux (gastrooesophageal reflux disease), sars-cov-2 test positive, colostomy, infection, pain, anticoagulant therapy, blood test abnormal. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210857180- COVID-19 VACCINE AD26.COV2.S-feeling cold, malaise, pyrexia, vomiting. This event(s) is labeled per Regulatory Authority and is therefore considered potentially related. 20210857180- COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1739936 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood folate, Blood pressure measurement, Blood sodium, Blood thyroid stimulating hormone, CSF test, Drug screen, Drug screen positive, Guillain-Barre syndrome, Haematocrit, Haemoglobin, Heart rate, Inappropriate antidiuretic hormone secretion, Liver function test, Magnetic resonance imaging head, Oxygen saturation, Polymerase chain reaction, Pseudohyponatraemia, Respiratory rate, Vitamin B12, White blood cell count
SMQs:, Peripheral neuropathy (narrow), Drug abuse and dependence (broad), Guillain-Barre syndrome (narrow), Hyponatraemia/SIADH (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bupropion
Current Illness: Alcohol use (on average, 6?8 beers per day); Anxiety; Depression; Marijuana use (daily).
Preexisting Conditions: Comments: The patient had been in a state of good health upon receipt of the vaccine 32 days prior.
Allergies:
Diagnostic Lab Data: Test Name: MRI brain; Result Unstructured Data: Evidence of focal enhancement; Test Name: Sodium; Result Unstructured Data: 134 mEq/L; Test Name: CSF test; Result Unstructured Data: Albuminocytological dissociation; Comments: Glucose of 73 mg/dL, an elevated protein to 181 mg/dL and 7 nucleated cells/high-power field (HPF; corrected for 2987 red blood cells/HPF), constituting albuminocytological dissociation.; Test Name: Blood pressure; Result Unstructured Data: 218/80 mmHg; Test Name: Heart rate; Result Unstructured Data: 85 {beats}/min; Test Name: Respiratory rate; Result Unstructured Data: 16 {breaths}/min; Test Name: Oxygen saturation; Result Unstructured Data: 100 %; Test Name: White blood cell count; Result Unstructured Data: 12.25 10*3/mL; Test Name: Hemoglobin; Result Unstructured Data: 16.7 g/dL; Test Name: Hematocrit; Result Unstructured Data: 49.5 L/L; Test Name: Liver function test; Result Unstructured Data: Within normal limits; Test Name: Thyroid stimulating hormone; Result Unstructured Data: Within normal limits; Test Name: Folate; Result Unstructured Data: Within normal limits; Test Name: Vitamin B12; Result Unstructured Data: Within normal limits; Test Name: Urine drug screen; Result Unstructured Data: Positive for tetrahydrocannabinol; Test Name: PCR; Result Unstructured Data: Negative; Test Name: Sodium; Result Unstructured Data: 124 mEq/L, Hyponatremia; Test Name: MRI brain; Result Unstructured Data: Bilateral enhancement of the cisternal segments of trigeminal nerves.
CDC Split Type: USJNJFOC20210941304

Write-up: SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE; PSEUDOHYPONATREMIA; URINE TOXICOLOGY/ URINE DRUG SCREEN TEST POSITIVE FOR TETRAHYDROCANNABINOL; ATYPICAL GUILLAIN-BARRE SYNDROME; This spontaneous report was received from literature: Guillain-Barre Syndrome Presenting as Facial Diplegia after COVID-19 Vaccination: A Case Report. The Journal of Emergency Medicine. 2021 Aug 07;1-5. This report concerned a 38-year-old male of unspecified race and ethnic origin. The objective of this report was to describe a case of an atypical presentation of GBS (Guillain-Barre Syndrome) presenting with extremity paresthesias, dysarthria, and bilateral facial weakness in the absence of classic ascending limb weakness, and discuss differential diagnosis, triage, and management. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: Anxiety, depression, alcohol user (average of 6 to 8 beers per day), and marijuana user (daily). The patient had been in a state of good health upon receipt of the vaccine 32 days prior. The patient received covid-19 vaccine adv26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown, expiry: UNKNOWN) dose, start therapy date were not reported, 1 total administered for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included bupropion for anxiety and depression. On an unspecified date, approximately 2 weeks after vaccination, the patient experienced subacute, rapidly progressive, numbness and tingling in the tongue, lips, bilateral hands and feet/ paresthesias. Two days prior to presentation the patient began to develop difficulty moving his mouth, forming words/ dysarthria/slurred speech, bilateral facial weakness/ facial diplegia/bilateral facial nerve palsy in a lower-motor-neuron pattern with acral paresthesias variant and an absence of classic ascending limb weakness, as well as difficulty drinking from a straw and controlling the lips, cheeks and tongue while eating. The review of systems was notable for headaches, mild gait unsteadiness, generalized fatigue and dyspnea on exertion. The patient denied diplopia, dysphagia, or dysphonia, chest pain or palpitations, lightheadedness, fevers or chills, nausea, vomiting or diarrhea, urinary or bowel incontinence and falls or other trauma. The patient visited the emergency department in a clinically good condition, not in acute distress and was ambulating independently. Initial vital signs were as follows, blood pressure 218/80 mmHg, heart rate 85 beats/min, respiratory rate 16 breaths/min and oxygen saturation of 100%. The patient exhibited weak eye closure bilaterally and inability to smile or puff cheeks against resistance. The extraocular movements were intact and tongue was midline without fasciculations. Strength in the upper and lower extremities were intact (5/5) as sensation to light touch throughout. There was no dysmetria or gait ataxia. Deep tendon reflexes were reduced 1 plus in the lower extremities and only faintly present in the bilateral upper extremities. Laboratory data were notable for a white blood cell count of 12.25 x 10E3/mL with a normal differential, hemoglobin of 16.7 gram per deciliter, and a hematocrit of 49.5 L/L. The serum chemistries including liver function test, thyroid-stimulating hormone, folate, and B12 (Cobalamin), were all within normal limits. Urine toxicology/ Urine drug screen test was positive for tetrahydrocannabinol and covid-19 polymerase chain reaction was negative. A neurology consultation was obtained. The brain magnetic resonance imaging (MRI) with and without contrast and constructive interference in steady state (CISS) sequencing revealed focal enhancement of the bilateral internal auditory canal fundi which carried the CN-VII (cranial nerve) and CN-VIII and the bilateral cisternal segments of the trigeminal nerves. Cerebrospinal fluid (CSF) analysis revealed glucose of 73 mg/dL, an elevated protein to 181 mg/dL, and 7 nucleated cells/high-power field (HPF; corrected for 2987 red blood cells/HPF), constituting albuminocytological dissociation suggestive of atypical Guillain-Barre syndrome. The electrodiagnostic evaluation was not performed as the CSF profile and clinical presentations were definitive of GBS. The patient was hospitalized and received intravenous immunoglobulin (IVIG) over 2 days to a total dose of 2 grams per kilo gram body weight, which showed a mild improvement in his symptoms. Measurements of negative inspiratory force was performed daily, and the patient had not developed any signs or symptoms of respiratory compromise. On hospital day 1, the patient developed new hyponatremia, which had reached a value of 124 mEq/L (milliequivalents per litre) during admission which was concluded to be multifactorial, attributed to pseudohyponatremia in the setting of IVIG as well as syndrome of inappropriate antidiuretic hormone in the setting of GBS. The patient was treated with fluid restriction and salt tabs with improvement in sodium to 134 mEq/L on discharge. The patient''s symptoms showed no further progression and was discharged home on hospital day 4. The duration of hospitalization were 4 days. The discharge examination was notable for stable to improvement in bilateral facial weakness and dysarthria with generalized areflexia. The author concludes that the patient received the Johnson and Johnson vaccine against the COVID-19 virus 32 days prior to presentation. In the Johnson and Johnson COVID19 vaccine trial, one case of GBS in the post-vaccination arm was reported, however, there was also a case of GBS in the placebo arm. This did not imply a causal association between the Johnson and Johnson COVID-19 vaccine and GBS. Author cannot say definitively whether the patient''s prior vaccination contributed to his development of GBS or was incidental to it. The risk of developing vaccine-associated GBS remains very low when viewed across the general population, and cases of GBS with a temporal association to vaccination are not necessarily caused by a vaccine-mediated immune response. Overall, the benefits of vaccination to prevent COVID-19 infection likely outweigh the risks of any potential adverse effects, including GBS, as stated in recent guidelines from the centers for disease control and world health organization. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from syndrome of inappropriate antidiuretic hormone, pseudohyponatremia, and atypical Guillain-Barre syndrome, and the outcome of urine toxicology/ urine drug screen test positive for tetrahydrocannabinol was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210941304-covid-19 vaccine ad26.cov2.s- pseudohyponatremia, syndrome of inappropriate antidiuretic hormone, Urine toxicology/ Urine drug screen test positive for tetrahydrocannabinol. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210941304-covid-19 vaccine ad26.cov2.s-atypical Guillain-Barre syndrome. This event(s) is labeled per RA and is therefore considered potentially related.


VAERS ID: 1739940 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-01
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Burning sensation, Chest discomfort, Chills, Cough, Diarrhoea, Discomfort, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Hypersomnia, Hypokinesia, Lymphadenopathy, Muscle fatigue, Musculoskeletal stiffness, Myalgia, Nasal discomfort, Nausea, Neck pain, Pain, Palpitations, Paraesthesia, Productive cough, Pyrexia, Rhinorrhoea, SARS-CoV-2 test, Slow speech, Tremor, Vomiting, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOCETIRIZINE
Current Illness: Asthma; Depression
Preexisting Conditions: Comments: The patient had no known allergies. The patient was taking depression medications
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: COVID-19 PCR test; Result Unstructured Data: Negative; Test Date: 20210916; Test Name: Body temperature; Result Unstructured Data: 102 F; Test Date: 20210922; Test Name: Body temperature; Result Unstructured Data: 100.8 F
CDC Split Type: USJNJFOC20210944355

Write-up: SEVERE COUGH; SHORTNESS OF BREATH; WHEEZING; SWEATING BUCKETS/DIAPHORESIS; COULDN''T MOVE; HAD TO SLEEPING LONG PERIODS TO HAVE ENERGY; LIGHTHEADEDNESS; CHILLS; FEVER; WEAKNESS/NO ENERGY; NAUSEA; VOMITING; SEVERE HEADACHES; ACUTE MUSCLE PAIN/ACUTE MYALGIA; STINGING SENSATION; FINGERS TINGLING (WEIRD SENSATION); FELT BURNING SENSATION; FOGGY MIND; CHEST TIGHTNESS; RHINORRHEA; PRESSURE AND DISCOMFORT IN EARS; EASILY FATIGUED MUSCLES; TREMBLING MUSCLES; PALPITATIONS; NECK PAIN; MUSCLE STIFFNESS; COUGH WITH CLEAR SPUTUM PRODUCTION; TALKS SLOWER; PRESSURE AND DISCOMFORT IN NASAL PASSAGES; SEVERE FATIGUE; BILATERAL CERVICAL LYMPHADENOPATHY; DIARRHEA THAT HAS RESOLVED; This spontaneous report received from a patient concerned a 38 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: depression, and asthma, and other pre-existing medical conditions included: The patient had no known allergies. The patient was taking depression medications. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 15-SEP-2021 for prophylactic vaccination. Concomitant medications included levocetirizine for asthma. On SEP-2021, the patient experienced foggy mind. On SEP-2021, the patient experienced chest tightness. On SEP-2021, the patient experienced rhinorrhea. On SEP-2021, the patient experienced pressure and discomfort in ears. On SEP-2021, the patient experienced easily fatigued muscles. On SEP-2021, the patient experienced trembling muscles. On SEP-2021, the patient experienced palpitations. On SEP-2021, the patient experienced neck pain. On SEP-2021, the patient experienced muscle stiffness. On SEP-2021, the patient experienced cough with clear sputum production. On SEP-2021, the patient experienced talks slower. On SEP-2021, the patient experienced pressure and discomfort in nasal passages. On SEP-2021, the patient experienced severe fatigue. On SEP-2021, the patient experienced bilateral cervical lymphadenopathy. On SEP-2021, the patient experienced diarrhea that has resolved. Laboratory data included: COVID-19 PCR test (NR: not provided) Negative. On 15-SEP-2021, the patient experienced felt burning sensation. On 15-SEP-2021, the patient experienced stinging sensation. On 15-SEP-2021, the patient experienced fingers tingling (weird sensation). On 16-SEP-2021, the patient experienced sweating buckets/diaphoresis. On 16-SEP-2021, the patient experienced couldn''t move. On 16-SEP-2021, the patient experienced had to sleeping long periods to have energy. On 16-SEP-2021, the patient experienced lightheadedness. On 16-SEP-2021, the patient experienced chills. On 16-SEP-2021, the patient experienced fever. On 16-SEP-2021, the patient experienced weakness/no energy. On 16-SEP-2021, the patient experienced nausea. On 16-SEP-2021, the patient experienced vomiting. On 16-SEP-2021, the patient experienced severe headaches. On 16-SEP-2021, the patient experienced acute muscle pain/acute myalgia. Laboratory data included: Body temperature (NR: not provided) 102 F. On 19-SEP-2021, the patient experienced severe cough. On 19-SEP-2021, the patient experienced shortness of breath. On 19-SEP-2021, the patient experienced wheezing. On 22-SEP-2021, Laboratory data included: Body temperature (NR: not provided) 100.8 F. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea that has resolved on SEP-2021, was recovering from felt burning sensation, fingers tingling (weird sensation), fever, chills, weakness/no energy, sweating buckets/diaphoresis, couldn''t move, had to sleeping long periods to have energy, nausea, vomiting, severe headaches, lightheadedness, acute muscle pain/acute myalgia, chest tightness, severe fatigue, rhinorrhea, pressure and discomfort in ears, easily fatigued muscles, trembling muscles, palpitations, neck pain, muscle stiffness, cough with clear sputum production, bilateral cervical lymphadenopathy, foggy mind, talks slower, stinging sensation, and pressure and discomfort in nasal passages, and had not recovered from severe cough, shortness of breath, and wheezing. This report was non-serious. This case, from the same reporter is linked to 20210944068.; Sender''s Comments: V0: Medical Assessment Comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1739946 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Body temperature, Body temperature increased, Chest X-ray, Chest discomfort, Cough, Dyspnoea, Electroencephalogram, Fatigue, Feeling abnormal, Hypersensitivity, Muscle tightness, Pain in extremity, Palpitations, Peripheral swelling, Rhinorrhoea, SARS-CoV-2 test, Sneezing, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EUTHYROX; GLUCOPHAGE [METFORMIN]
Current Illness: Abstains from alcohol; Hashimoto''s disease; Insulin resistance; Non-smoker; Polycystic ovarian syndrome (taking contraceptive pills)
Preexisting Conditions: Comments: The Patient stated that she ate healthy, exercise regularly.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: elevated; Test Name: EEG; Result Unstructured Data: Normal; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Name: Chest X-ray; Result Unstructured Data: everything looked normal; Test Name: Blood test; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210947006

Write-up: CALVES SWOLLEN; HEART RACING; CALVES TENSE; FEELING BAD; HEAVINESS IN CHEST, ESPECIALLY IN HORIZONTAL POSITION; LEGS HURTING; HANDS SHAKING; WORSENING BREATHING PROBLEM; TIREDNESS; ALLERGY; ELEVATED TEMPERATURE; SNEEZING; RUNNING NOSE; STRONG COUGH; This spontaneous report received from a patient concerned a 31 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: pcos (polycystic ovarian syndrome), hashimoto''s disease, insulin resistance, non smoker, and non alcoholic, and other pre-existing medical conditions included: The Patient stated that she ate healthy, exercise regularly. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included levothyroxine sodium for hashimoto''s disease, and metformin for insulin resistance. On AUG-2021, the patient experienced running nose. On AUG-2021, the patient experienced strong cough. On AUG-2021, the patient experienced sneezing. On AUG-2021, the patient experienced worsening breathing problem. On AUG-2021, the patient experienced tiredness. On AUG-2021, the patient experienced allergy. On AUG-2021, the patient experienced elevated temperature. Laboratory data included: Body temperature (NR: not provided) elevated. Treatment medications included: paracetamol. On an unspecified date, the patient experienced calves swollen, heart racing, hands shaking, calves tense, feeling bad, heaviness in chest, especially in horizontal position, and legs hurting. Laboratory data (dates unspecified) included: Blood test (NR: not provided) Normal, COVID-19 virus test (NR: not provided) Negative, Chest X-ray (NR: not provided) everything looked normal, and EEG (NR: not provided) Normal. Additional treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tiredness, elevated temperature, strong cough, legs hurting, calves swollen, heart racing, hands shaking, worsening breathing problem, calves tense, feeling bad, heaviness in chest, especially in horizontal position, and allergy, and the outcome of sneezing and running nose was not reported. This report was non-serious.


VAERS ID: 1740798 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-16
Onset:2021-09-23
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Abortion threatened, Full blood count, Human chorionic gonadotropin decreased, Maternal exposure before pregnancy, Platelet count increased, Pregnancy test positive, Thrombosis, Ultrasound pelvis abnormal, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow), Fertility disorders (narrow)

Life Threatening? Yes
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Pelvic ultrasound 9/23/21 CBC 9/23/21 Hcg 9/23/21 1464 Platelets 426 Hcg 9/27/21 372 Platelets 410 Platelets 271 7/23/21 (for reference prior to receiving vaccine)
CDC Split Type:

Write-up: On 9/10/21 I had a positive pregnancy test. On 9/23/21 while at work I started passing large blood clots and bleeding. I went to the Emergency Room at Hospital. Platelet count was abnormally high and the pelvic ultrasound showed no viable pregnancy. I was discharged with threatened miscarriage diagnosis and told to repeat hcg levels and CBC on 9/27/21. I passed more clots over the weekend and on 9/27/21 my hcg levels had dropped from 1400?s to 300?s and platelets were still abnormally high. Confirmed miscarriage


VAERS ID: 1740821 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-27
Onset:2021-08-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / N/A - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Chest X-ray, Chest discomfort, Chills, Dizziness, Dyspnoea, Electrocardiogram, Tachycardia, Troponin
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: cefaclor--hives
Diagnostic Lab Data: Chest x ray is unremarkable, EKG is WNL. Troponins are undetectable.
CDC Split Type:

Write-up: Patient received J & J vaccine in the morning. By 4 pm, patient presented to ER with complaints of chills, lightheadedness, shortness of breath, chest tightness radiating to upper back. Patient is tachycardic (heart rate = 107). Patient has temp of 100.4 F. Patient is treated with IV acetaminophen, ketorolac, and IV fluids. Vital signs normalized and patient is discharged home.


VAERS ID: 1740847 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-16
Onset:2021-09-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Atrioventricular block, Chest discomfort, Costochondritis, Electrocardiogram abnormal, Fatigue, Magnetic resonance imaging, Myocarditis, Palpitations, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: covid prior
Preexisting Conditions: none
Allergies: amoxicillin
Diagnostic Lab Data: EKG showed heart block, MRI and Ultrasound still pending
CDC Split Type:

Write-up: First day heart palpitations began along with chest tightness. Day 2 pain in heart region began developing further with continued palpitations and chest tightness. By Day 4, was admitted to ER and diagnosed with costocondritis and heart block. All symptoms remaining along with immense fatigue, cardiologist diagnosed myocarditis.


VAERS ID: 1740855 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Blood pressure increased, Blood test, Dyspnoea, Electrocardiogram, Fatigue, Feeling hot, Fibrin D dimer, Full blood count, Hypersomnia, Metabolic function test, Pain, Pain in extremity, Palpitations, Paraesthesia, Paraesthesia oral, Pyrexia, Swelling, Throat tightness, Thyroid function test, Troponin, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Armodafinil, Lo Loestrin, B Complex, D3, Magnesium Citrate, Zinc, C, Iron
Current Illness: Unknown
Preexisting Conditions: Gastroparesis, Epstein Barr, Narcolepsy
Allergies: Unknown
Diagnostic Lab Data: Pending results.
CDC Split Type:

Write-up: September 15, 2021: Received Johnson and Johnson COVID vaccine in left arm. Within 5ish minutes felt a "warm rush", blurred vision, racing heart, shortness of breath. Nurse took blood pressure and told me it was elevated but my oxygen was 100%. Nurse stayed with me until felt well enough to go home. At home I began to feel pins and needles in my left hand. September 16, 2021: Experienced extreme fatigue and exhaustion. Had low grade fever of 101 F. Felt achy and developed cramping in left calf which traveled to my left clavicle. Went to ER. Exam and EKG was normal. Declined additional testing that that time. September 20, 2021: Experienced sensation of throat closing as well as tingling of hands, feet and lips. Led to 2nd visit to ER. Normal exam, Blood work included a normal CK, CBC, CMP, thyroid function, and troponin level. D-dimer was normal as well. Declined CT and was recommended to see Neurologist. September 21, 2021: While driving experienced tingling in hands and feet. Unable to open or close hand. Pulled over at gas station and asked worker for ER medical assistance. Once again, vitals came back normal. Declined trip to ER and had husband drive me home. September 27, 2021: Still has significant fatigue. Intermittently experiences paresthesia of hands and feet. Cramping in both calves. Feels swollen in face and hands. Caffeine triggers a panic attack sensation. Sleeping excessively despite continuing to use Armodafinil. Had MRI and blood work for ANA and sedimentation rate. Additional tests have been scheduled for EMG, blood work for B12 and copper level.


VAERS ID: 1740950 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-28
Onset:2021-07-01
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood cholesterol increased, Urticaria, Weight increased
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Lipodystrophy (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allergy medicine; Tylenol
Current Illness: None
Preexisting Conditions: In November of last year I had a stroke. The following December I had Covid 19, arthritis
Allergies: Seasonal; Penicillin; Latex; Prednisone; adhesive tape
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: 2 months ago I broke down in hives. It started out in my feet. It escalated to all over my body. My daughter took pictures of it. I went to the ER. They said it was a really bad case of hives. They gave me Benadryl and that did not work. I went back and they gave me a shot of steroids and shot of Benadryl. The hives lasted for 4 days before it all went away. Also, it is affecting my weight gain. My cholesterol went from 100 to 400. My doctor put me in a diet and told me to exercise.


VAERS ID: 1740967 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-24
Onset:2021-05-01
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood iron decreased, Blood test abnormal, Computerised tomogram normal, Condition aggravated, Contusion, Dizziness, Dyspnoea, Epstein-Barr virus infection, Erythema, Fatigue, Fibrin D dimer increased, Flushing, Haemoglobin decreased, Haemoglobin increased, Heart rate increased, Hyperhidrosis, Hypoaesthesia, Inflammatory marker increased, Joint swelling, Magnetic resonance imaging head, Muscle spasms, Oesophagogastroduodenoscopy normal, Pain, Peripheral swelling, Red blood cell sedimentation rate increased, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (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), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Opportunistic infections (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Esomeprazole magnesium; sertraline; clonazepam.
Current Illness: GERD
Preexisting Conditions: GERD, depression and anxiety.
Allergies: Singular
Diagnostic Lab Data: Blood work - low iron and hemoglobin, high SED rate, EGD - normal, capsule endoscopy - normal, CT scan- no PE (had a high D-dimer), MRI of brain - results pending
CDC Split Type:

Write-up: Extreme fatigue started in May. I get episodes where I get flushed, rapid heart rate, feeling of passing out, sweaty, short of breath. I''d have to lay down sometimes after an episode due to extreme fatigue. Couldn''t muster strength to continue working out. Tried donating blood and hemoglobin was at 8.8. Followed up with PCP. Low iron and low hemoglobin. Have had an EGD to rule out slow bleed. Multiple blood work. Iron infusion, which I had an adverse reaction to. Thyroid normal. Inflammatory markers are high but that''s normal for me due to Hashimotos. Tested positive for Epstein Barr virus (had in past but not sure when). No Lyme disease. No odd white blood cell counts. Around May I also started to experience waking up with swollen joints. My thumb area on hand would swell up, be hot and red, kind of numb. Prednisone got rid of it first time. Now when I get it, I let it be becauseI don''t want to continuously take steroids . It''s been both hands/thumb areas, wrists, knees, and ankles. I have a constant left lower calf cramp that won''t go away. Bruise easily. I''m still tired. All the time. My body aches. All the time. I feel as though I''ve aged 20 years in 6 months.


VAERS ID: 1740968 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-03
Onset:2021-05-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: Patient presented to the ED at Hospital on 5/7/21. Patient presented with signs of a stroke. Patient was transferred to another hospital to receive a higher level of care.


VAERS ID: 1741126 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-22
Onset:2021-09-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Electrocardiogram normal, Heart rate increased, Laboratory test normal, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: seasonal flu vaccine
Other Medications: vitiamins D and C and zinc
Current Illness: none
Preexisting Conditions: none
Allergies: amoxicillin, clarithromycin, tetracyline, atrificial sweetners, soy products
Diagnostic Lab Data: all test and results are in my medical record all i was told was my labs were all within normal limits on both 9-22-21 as well as the next day on 9/23/21. they told me my xray was fine without any concers and my ekg had returned to normal
CDC Split Type:

Write-up: Aproximately 3hrs after recieving vaccine for covid my heart rate spointaniously jumped into the 180 and stayed rapid tachycardiac for about 12 hous . i went to a walkin in and was sent by emt"s to hospital. had blood tests multiple ekgs and a chest xray. administer fluids and vit k as well as diltiazem. and at some point my heart rate just flipped back to a normal sinus rythem. was admitted for 24 hrs then discharged to follow up with my pcp and a cardioligist


VAERS ID: 1741239 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-25
Onset:2021-04-06
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest pain, Colonoscopy, Computerised tomogram, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Gastrointestinal tube insertion, Intestinal obstruction, Pallor, Pulmonary embolism, SARS-CoV-2 test negative, Thrombosis, Ultrasound Doppler abnormal, X-ray
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal obstruction (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Citalopram 20 mg once a day Clozapine tablet 200 mg once a day /100 mg once a day Famotidine once a day Fenofibrate once a day Iron infusion Ferrlecit 125 mg 8 days total for the month Levothyroxine sodium 75 mcg once a day Omega 3 gummies
Current Illness: N/A
Preexisting Conditions: Iron deficiency High cholesterol Hyperthyroidism Overweight Blood clot in right leg
Allergies: N/A
Diagnostic Lab Data: He was in the hospital for 9 days. Covid-19 test on 04/08/2021 - negative result CT scan EKG X-ray Doppler NG tube Colonoscopy He was discharged on 04/16/2021. Then he had monthly doctor follow-ups.
CDC Split Type: vsafe

Write-up: On 04/06/2021, he experienced these symptoms: chest pain, fatigue, shortness of breath, paleness, and dizziness. On 04/08/2021, he went to the ER. It was discovered that he had a blood clot in the lower left leg, a bilateral embolism in both lungs, and a partial bowel obstruction. He was put on Eliquis, steroids, and breathing treatments.


VAERS ID: 1741279 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-28
Onset:2021-06-21
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Bell's palsy, Bowel movement irregularity, Dysarthria, Guillain-Barre syndrome, Laboratory test
SMQs:, Peripheral neuropathy (narrow), Taste and smell disorders (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Was diagnosed on 06/21/2021 with Bells Palsy and it affected the right side of his face causing slurring of words, lost of taste and smell. Has been told by doctor that he may have Guillain-Barr? syndrome. No bowel movement.


VAERS ID: 1741424 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-24
Onset:2021-09-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Erythema, Eye swelling, Headache, Hypersensitivity, Lip swelling, Pyrexia, Swelling face, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Periorbital and eyelid disorders (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinpril, Escitalopram, Dietary vitamin,
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa, Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 24 hours after shot chills and fever started. 36 hours after shot swelling of eyes, face, lips started. 48 hours after shot eyes were swollen shut, red to the face and still had chills, fever, headache. At this time on September 26th at approximately 11pm went to our local hospital emergency room. After seeing doctor determined I had a reaction to the shot. They prescribed Prednisone 10mg and sent home. On September 29th in the am all symptoms were gone.


VAERS ID: 1741517 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-04-02
Onset:2021-04-11
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis, Fatigue, Gait disturbance, Laboratory test, Magnetic resonance imaging, Muscular weakness, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hearing impairment (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: My primary Doctor ordered several tests of which some were mishandled by the Lab and never yielded any results. The Hospital also took many tests, including an MRI, when I was at their emergency room on April 21, 2021. I do not have access to all the results but left there with medication for Belles Pares, with an unknown cause. This was before the risk of getting Guillain-Barre Syndrome from the J&J vaccine was discovered.
CDC Split Type:

Write-up: The symptoms started 9 days after the J&J shot, with very severe muscle pain (worsening during nights) during the first week. This turned into a facial paralysis (17 days after the shot) followed by about 5 months of tingling in fingertips, fatigue and muscle pain/weakness in legs and difficulty to walk properly. I have an appointment with a neurologist in October but this will probably be too late as I felt fully recovered since about three weeks. That is why I wanted to report this to ensure that it is in the systems.


VAERS ID: 1741602 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-17
Onset:2021-05-16
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen Colchicine
Current Illness:
Preexisting Conditions: Borderline, Rosacea, Anxiety and Depression, Endometriosis
Allergies: Seroquel, Zyprexa, Gabapentin, Risperidone
Diagnostic Lab Data:
CDC Split Type:

Write-up: myopericarditis


VAERS ID: 1741701 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-28
Onset:2021-09-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hypopnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Respiratory failure (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: Albuterol as needed, last dose 9/27/2021. Patient denies using any other medications,, supplements or herbal remedies.
Current Illness: Patient denies acute illness.
Preexisting Conditions: Asthma
Allergies: Eggs, miralax, oxycodone
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: 1300-Janssen vaccination 0.5ml administered into left deltoid. Patient ambulated to monitoring section of vaccination clinic. 1304- Patient reported complaints of shortness of breath and stated that she has a history of asthma. On assessment patient''s skin color was normal for patient, rapid shallow breathing at approximately 36 bpm, patient was AOx4 and was able to independently slow her breathing down with instruction, patient''s lung sounds were CTA BL.Patient reported that she had her Albuterol MDI in her car, EMT sent to patient''s car to retrieve MDI. Initial vital signs were SaO2 98% RA, HR 119, RR 36. 1307- Patient attempted to administer MDI to herself, patient was observed covering the mouth piece of the MDI and therefore was not able to inhale the medication. At that time this RN administered 3 puffs of MDI while patient closed her mouth over the mouth piece and inhale deeply. Patient remained AOx4 and continued to follow instruction to slow her breathing down. Vitals signs BP 178/96 HR 127, RR 32, SaO2 98%. Lungs CTA BL. 911 was called. 1311- Patient was given 50mg diphenhydramine PO. Patient was able to swallow PO medication without difficulty. Patient had complaints of dizziness. Patient was assisted from a chair to the prone position on the ground. 1317: EMS arrived. Report provided to EMS provider, questions answered, understanding verbalized. Patient ambulated independently to EMS stretcher and was able to independently position herself onto the stretcher. 1320- Patient transported to ER via ambulance.


VAERS ID: 1741710 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-11
Onset:2021-09-07
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Gait disturbance, Pain in extremity, Peripheral swelling, Skin reaction, Skin warm, Tenderness, Thrombosis, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations: flu vaccine in multidose vial caused anaphylaxis
Other Medications: aspirin 325 mg one tablet per day
Current Illness: none
Preexisting Conditions: none
Allergies: old-fashioned iodine contrast dye; flu vaccine in multi-dose vials--both caused anaphylactic reaction. Has sunsequently had preservative-free flu vaccine each year with no problems.
Diagnostic Lab Data: ultrasound 9/7/2021
CDC Split Type:

Write-up: Received vaccine on 8/11/2021. While in location for work, he experienced severe left leg pain and marked swelling on 9/7/2021. He went to the emergency department and saw a physician assistant whose name he does not recall. He had a blot clot diagnosed by ultrasound. The PA told him "it''s not a DVT but the clot is deeper than a superficial thrombophlebitis." The area was markedly swollen, very tender, red and warm to the touch, and caused difficulty with walking. 4 days later it has substantially improved and is almost completely resolved at this point; swelling is gone, no redness, just tender.


VAERS ID: 1741713 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-15
Onset:2021-09-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Positive for COVID-19 August 10th, 2021
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chest pains, myocarditis


VAERS ID: 1741754 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Anxiety, Back pain, Chest discomfort, Chest pain, Computerised tomogram, Dizziness, Dyspnoea, Ear pain, Electrocardiogram, Fatigue, Headache, Heart rate increased, Joint stiffness, Neurological examination, Pain in jaw, Paraesthesia, Pelvic organ prolapse, Ultrasound scan, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: EKG 04/06/2021 Cat-Scan 04/06/2021 Ultrasound 04/06/2021
CDC Split Type:

Write-up: Pt.''s Father states that after receiving the 1st dose of J&J 04/06/2021, started experiencing symptoms of high heart rate (159), chest pain, shortness of breath, back pain, jaw pain, headaches, light headness, chronic ear pain, fatigued, tightness in the chest, anxious, vomiting, tingling in the hands and face, tightness in the joints, and upset stomach. "POPS" diagnosed by Primary. 7 Urgent Care visits noted (unknown dates), Neurologist visit 09/24/2021, MRI (heart) scheduled 10/01/2021. GI appointment scheduled due to stomach pains. Still experiencing symptoms.


VAERS ID: 1741861 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Hypoaesthesia, Neck pain, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, 20mg 1x daily
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data: Urgent Care visit on September 16, 2021
CDC Split Type:

Write-up: Left Arm Pain - Severe. Area of numbness in/on arm. Pain increasing. Pain still intense today over 2 months post vaccine. Stinging sensation in arm. Burning sensation in Arm. At times, pain moving upwards to shoulder, lower neck. At times, pain travels down arm towards hand.


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