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From the 5/7/2021 release of VAERS data:

Found 188,897 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

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VAERS ID: 1281954 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: A 16-year-old patient was inadvertently given the Johnson & Johnson COVID-19 vaccine approved for 18-years-old and older. No adverse reactions were notes at time of vaccination or during observation time.


VAERS ID: 1281980 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: A 17-year-old patient was inadvertently given the Johnson & Johnson COVID-19 vaccine approved for 18-years-old and older. No adverse reactions were notes at time of vaccination or during observation time.


VAERS ID: 1281985 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Head discomfort, Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Pt says within about 15 minutes of vaccine, she had tingling in hands and feet, tingling in her upper lip, and she felt like there was a rubber band around her head. I ave her water and referred her to the urgent care next door. When I followed up with her today (5.3), she says the symptoms self-resolved and she never received any actual medical attention


VAERS ID: 1282045 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event
SMQs:

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

Write-up: PATIENT WAS GIVEN THE J&J COVID VACCINE DOSE OUTSIDE THE 6 HOUR WINDOW. After contacting patient no unusual side effects reported.


VAERS ID: 1282051 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-31
Onset:2021-04-30
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Erectile dysfunction, Fatigue, Feeling abnormal, Libido decreased, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma diagnosis (no medication for it), obese
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brain feels foggy or groggy, as if I am depressed, or really tired, no matter if I get enough sleep or not. Have not been able to attain or maintain an erection in two weeks, my sex drive is 100% dead. I used to have an extremely strong sex drive until 2 weeks ago. Something is very, very wrong with me.


VAERS ID: 1282053 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Paraesthesia, Presyncope
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient reported having similar episode several years prior, but did not report which vaccine was administered at that time.
Other Medications: Lorazepam 0.5 mg - given by prescriber specifically due to patient''s anxiety about the vaccination. No other concurrent medications reported.
Current Illness: None reported.
Preexisting Conditions: Breast cancer - in remission for 6 years per patient
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported that she had a history of fainting after receiving other vaccines, so she had her friend drive her and got the vaccine administered in her car. A few minutes after getting the vaccine, the patient appeared to have a vasovagal episode where she stared off into the distance and stopped responding to questions for about 30 seconds to 1 minute before coming to. She reported having some tingling in her fingers and feeling a little weak afterwards. Provided the patient with a wet cloth for her forehead and some candy. Patient was a little shaken up but seemed to be back to normal in a few minutes. Contacted EMS just to be sure, and they checked her pulse and blood pressure, which were a little elevated but within normal limits. Patient said she was feeling better and did not need to go with them to the hospital. After waiting a few more minutes, she reported that she was feeling mostly back to normal and her friend drove them back home.


VAERS ID: 1282322 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood pressure increased, Blood test, Chest discomfort, Dry mouth, Electrocardiogram, Heart rate increased, Paraesthesia oral, Visual impairment
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: chest feeling heavy, vision change, increase BP, Increase heart rate, dry mouth, tongue felt funny


VAERS ID: 1282404 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK LA / SYR

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

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

Write-up: Extremely tired; flushed face; fever of 99.8; upper body aches.


VAERS ID: 1282480 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Body temperature fluctuation, Erythema, Fatigue, Headache, Nausea, Pain, Peripheral swelling, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Temp dysregulation (few days), headache(on and off), body aches(1day), fatigue(on and off), nausea(on and off), arm swelling/redness/tenderness(several days), stomach discomfort(few days). Rolaids, Tylenol, aleve, rest, water.


VAERS ID: 1282638 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-10
Onset:2021-04-30
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity, Thrombosis, Ultrasound scan abnormal
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: None
Preexisting Conditions: HTN, Hypothyroidism, Sjogren''s Syndrome, A-Fib, Asthma
Allergies: Shell Fish, Almonds Pollen, Mold, Dogs, Weeds Sulfa Drugs, PEG, Erythromycin, Macrobid Latex
Diagnostic Lab Data: Ultrasound done on 4-30-2021.
CDC Split Type:

Write-up: Ultrasound done on 4-30-2021 for pain in calf of left leg and numbness of the toes for 7 days. Result came back positive for blood clot.


VAERS ID: 1282979 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-30
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrioventricular block second degree, Back pain, Bradycardia, Cardiac pacemaker insertion, Dyspnoea, Heart rate decreased
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Brilinta 90 mg (2/day) Aspirin 81 mg (1/day) Metformin 500 (1/day) Farxiga 50 mg (1/day) Pravastatin 20 mg (1/day) Alprazolam 0.25 mg (1/day) Lantus 10 units (twice daily) Humalog (as needed) Xopenex HFA (as needed) Advair Diskus (once dail
Current Illness: None
Preexisting Conditions: Diabetic Heart Stent Tuberculosis (competed program 5/2020)
Allergies: None
Diagnostic Lab Data: Admitted to Medical facility All tests preformed there Under care
CDC Split Type:

Write-up: Diagnosed with Bradycardia; Dyspnea; Mobitz Type II A-V Block Low heart rate 30s-40s; Currently monitoring with outcome of pacemaker implant


VAERS ID: 1284271 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure decreased, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient experienced light fainting, lower blood pressure after getting her vaccine. Patient''s vitals were normal, patient was observed for 30 min by EMS. Patient felt fine after 30 min. Patient didn''t need any treatment.


VAERS ID: 1284443 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-30
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram abdomen abnormal, Magnetic resonance imaging abdominal abnormal, Pancreatitis acute
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluoxetine-80mg Hailey 1.5/30 Adderall XR-30mg
Current Illness:
Preexisting Conditions: polycystic ovarian syndrome depression anxiety OCD
Allergies: Amoxicillin
Diagnostic Lab Data: CT scan- 4/30/2021 MRI- 5/1/2021
CDC Split Type:

Write-up: acute pancreatitis


VAERS ID: 1284702 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bone pain, Hypoaesthesia, Peripheral coldness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies, no significant medical history and medications.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210501517

Write-up: NUMBNESS IN FEET; COLD FEET AND COLD FINGERNAILS ON LEFT HAND; PAIN IN BONES OF FEET; This spontaneous report received from a patient concerned a 49 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies, no significant medical history and medications. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: 23-JUN-2021) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-APR-2021, the subject experienced numbness in feet. On 30-APR-2021, the subject experienced cold feet and cold fingernails on left hand. On 30-APR-2021, the subject experienced pain in bones of feet. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pain in bones of feet on 01-MAY-2021, and had not recovered from numbness in feet, and cold feet and cold fingernails on left hand. This report was non-serious.


VAERS ID: 1284705 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210501593

Write-up: DOSE ADMINISTERED FROM VIAL PUNCTURED FOR MORE THAN 6 HOURS; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported,) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 30-APR-2021, the subject experienced dose administered from vial punctured for more than 6 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of dose administered from vial punctured for more than 6 hours was not reported. This report was non-serious.


VAERS ID: 1284706 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Tongue discolouration
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210501611

Write-up: PARTIAL BLACK TONGUE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 12:00 for prophylactic vaccination. No concomitant medications were reported. On 30-APR-2021, the subject experienced partial black tongue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of partial black tongue was not reported. This report was non-serious.


VAERS ID: 1284934 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503675

Write-up: ACHE; CHILLS; FEVER; This spontaneous report received from a parent concerned a 24 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-APR-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 30-APR-2021, the subject experienced ache. On 30-APR-2021, the subject experienced chills. On 30-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chills, fever and ache was not reported. This report was non-serious.


VAERS ID: 1285587 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

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

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

Write-up: Facial swelling on the right side, arm showed no swelling


VAERS ID: 1285655 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-29
Onset:2021-04-30
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A021A / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Cough, chill, dyspnea developed 4/30/2021


VAERS ID: 1286309 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Dehydration, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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

Write-up: Fever, chills, severe nausea, dehydration; required trip to ER to receive fluids and anti-nausea meds


VAERS ID: 1286328 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Dosing error, this was the patients second dose of the one-dose Janssen Covid19 vaccine. First dose was more than one month earlier (3/11). Patient indicated on the questionnaire that they had not previously received a COVID19 vaccine. No adverse outcomes and patient was ok, with no unusual adverse reactions.


VAERS ID: 1286641 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-30
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fibrin D dimer, Throat tightness, Urticaria, White blood cell count increased
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Scoliosis
Allergies: None
Diagnostic Lab Data: D dimer 1450 WBC elevated
CDC Split Type:

Write-up: Broke out in hives consistently, shortness of breath, throat tightening. Hives are not clearing up. D dimer 1450.


VAERS ID: 1287625 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Disturbance in attention, Fatigue, Hepatic pain, Injection site pain, Injection site swelling, Nausea, Tinnitus
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Hypoglycaemia (broad)

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

Write-up: Severe arm pain/low swelling in arm area. Nausea. Pain near liver area. General fatigue. Mental cloudiness. Random bouts of tinnitus in both ears, switching off, never both ears at once. The arm pain and swelling in shot area lasted about two days, but the nausea, ;over pain, and fatigue continued for the better part of 4 days after the shot. The tinnitus only happened a couple times about 1-3 hours after the vaccination then ceased. I did not get this verified by a doctor, but I suspect my liver pain was related to an inflammation in the liver associated with the vaccine, as in the past, pain around my liver area has been associated with inflammation of my liver during minor flare ups.


VAERS ID: 1287940 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043821A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Chills, Erythema, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210430; Test Name: Body temperature; Result Unstructured Data: 103 F
CDC Split Type: USJNJFOC20210502306

Write-up: RED HANDS; CHILLS; FEELING WEAK; FEVER OF 103; This spontaneous report received from a patient concerned an 18 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 043821A expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-APR-2021, the subject experienced red hands. On 30-APR-2021, the subject experienced chills. On 30-APR-2021, the subject experienced feeling weak. On 30-APR-2021, the subject experienced fever of 103. Laboratory data included: Body temperature (NR: not provided) 103 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from red hands, chills, feeling weak, and fever of 103 on 02-MAY-2021. This report was non-serious.


VAERS ID: 1287988 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Pain, Pain in extremity, SARS-CoV-2 test, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Hematoma (Hematoma was present one on the hip and arms.); Comments: Patient had no known allergies and drug abuse and drug illicit use.
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: COVID-19 PCR test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210503939

Write-up: RED SPOT UNDER SKIN; BODY ACHES; HEADACHE; PAIN IN ARM; This spontaneous report received from a patient concerned a 44 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included hematomas, and concurrent conditions included non alcoholic, and non smoker, and other pre-existing medical conditions included patient had no known allergies and drug abuse and drug illicit use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 205A21A expiry: 23-JUN-2021) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: COVID-19 PCR test (NR: not provided) Negative. On 30-APR-2021, the subject experienced pain in arm. On 01-MAY-2021, the subject experienced body aches. On 01-MAY-2021, the subject experienced headache. On 02-MAY-2021, the subject experienced red spot under skin. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, and headache on 02-MAY-2021, and pain in arm on 01-MAY-2021, and was recovering from red spot under skin. This report was non-serious.


VAERS ID: 1288042 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General physical condition (Employee reported that patient is very healthy so this surprised the employee)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210504063

Write-up: VERY TIRED; This spontaneous report received from a patient via a company representative concerned a 56 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included healthy. 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 30-APR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch number .No concomitant medications were reported. On 30-APR-2021, the subject experienced very tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from very tired. This report was non-serious.


VAERS ID: 1288642 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Blood glucose, Blood pressure measurement, Body temperature, Gait inability, Headache, Pain, Pain assessment, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VIVITROL
Current Illness: Alcohol use (twice a week.); Blood pressure high (145/110); Diabetic (with BLOOD GLUCOSE LEVEL OF 160 MG/D.); Hypercholesterolaemia; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies. The patient did not have any history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210430; Test Name: Pain scale; Result Unstructured Data: 10/10, pain level; Test Date: 20210430; Test Name: Body temperature; Result Unstructured Data: burning; Test Date: 20210501; Test Name: Pain scale; Result Unstructured Data: 05/10, pain level; Test Name: Blood pressure; Result Unstructured Data: 145/110 mmHg, high; Test Name: Blood glucose; Result Unstructured Data: 160 mg/dL
CDC Split Type: USJNJFOC20210502636

Write-up: THROBBING PAIN; UNABLE TO WALK (AFTER 4 HOURS OF VACCINATION); WAKE UP IN MIDDLE OF THE NIGHT (AFTER 4 HOURS OF VACCINATION); PAIN IN HIS SHOULDER AND ARM JOINTS; SEVERE HEADACHE/DULL PAIN ON TOP OF HEAD (AFTER 4 HOURS OF VACCINATION); FEVER; This spontaneous report received from a patient concerned a 57 year old male. The patient''s weight was 182 pounds, and height was 165 centimeters. The patient''s concurrent conditions included high cholesterol level, diabetic, high blood pressure, alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no known allergies. the patient did not have any history of drug abuse or illicit drug use. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 1805020, and expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. Concomitant medications included naltrexone for alcohol dependence. On 30-APR-2021, the subject experienced throbbing pain. On 30-APR-2021, the subject experienced unable to walk (after 4 hours of vaccination). On 30-APR-2021, the subject experienced wake up in middle of the night (after 4 hours of vaccination). On 30-APR-2021, the subject experienced pain in his shoulder and arm joints. On 30-APR-2021, the subject experienced severe headache/dull pain on top of head (after 4 hours of vaccination). On 30-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) burning, and Pain scale (NR: not provided) 10/10 pain level. On 01-MAY-2021, Laboratory data included: Pain scale (NR: not provided) 05/10 pain level. Laboratory data (dates unspecified) included: Blood glucose (NR: not provided) 160 mg/dL, and Blood pressure (NR: not provided) 145/110 mmHg. The action taken with covid-19 vaccine was not applicable. The patient was recovering from severe headache/dull pain on top of head (after 4 hours of vaccination), and fever, had not recovered from pain in his shoulder and arm joints, and the outcome of throbbing pain, unable to walk (after 4 hours of vaccination) and wake up in middle of the night (after 4 hours of vaccination) was not reported. This report was non-serious.


VAERS ID: 1288954 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-04-30
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Malaise, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient received J and J vaccine on 03/31/2021 started feeling sick with a sore throat tested positive for covid on 04/30/2021


VAERS ID: 1289245 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Feeling cold, Night sweats, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: allergic to crabs once in 2012.
Diagnostic Lab Data: no
CDC Split Type:

Write-up: After 12 h, i feel cold with low fever, mild sweating during sleep, they lasted for two nights. diarrhea started 1:30 am on day 2, with 3 times of water stools in total on day 2.


VAERS ID: 1289336 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Eyelid function disorder, Hyperacusis, Lumbar puncture, Magnetic resonance imaging, Migraine, Nausea, Photophobia, Thunderclap headache, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, Bupropion
Current Illness: None
Preexisting Conditions: Anxiety, OCD, and General Panic Disorder
Allergies: Sulfa
Diagnostic Lab Data: 04/30/2021 - MRI, CT Scan, CT Scan with contrast, Lumbar Puncture
CDC Split Type:

Write-up: Thunderclap Migraine, Blurred vision in right eye, right eye lid would not remain open. Sensitivity to light and sound. Dizziness. Nauseous. Started at 1:00 am, called Primary. Advised since I do not suffer from migraines to go to the ER. I was given a Migraine Cocktail. An MRI of my brain, and CT scan. They attempted the lumbar puncture and were unsuccessful in retrieving.


VAERS ID: 1289423 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Initial insomnia, Tinnitus, Vaccination complication
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin (Known by Primary Doctor) Not aware of other drugs/ingredients I am allergic to.
Diagnostic Lab Data: Nothing yet.
CDC Split Type:

Write-up: I am experiencing slight ringing in what appears to be my right ear. I don''t know if it is both ears. I have not seen my primary doctor yet. The feeling is similar to having head congestion or sinus pressure, I guess. It is not an emergency for me. I will be checking with my primary doctor soon. The only discomfort I have is when I try to fall asleep. I hear the slight ringing in my right ear. Still optimistic that it will go away on its own. I am tolerating it at the moment and can work throughout the day. But, sleeping appears to be the most interruptive. With that being said, I do end up falling asleep. I am pretty sure this is a vaccine reaction. I have not had any history of it before. As soon as I see my doctor, I will update the notes for more clarity on what these symptoms are. Thank you.


VAERS ID: 1289761 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Patient received vaccine under the approved age. No adverse events noted.


VAERS ID: 1289785 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Patient was given vaccine under the approve age range. No adverse events noted.


VAERS ID: 1289805 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-30
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B12, D, K , B6 zinc Selenium Iodine
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: positive COVID on 5/4/2021
CDC Split Type:

Write-up: Patient developed nasal congestion, cough and fatigue 1 month after receiving COVID vaccine. Patient subsequently tested positive


VAERS ID: 1289931 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-30
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JNJ1808982 / UNK LA / SYR

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

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

Write-up: Recurring headaches and migraines, bruising on legs


VAERS ID: 1290025 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood glucose abnormal, Chills, Decreased appetite, Diabetic ketoacidosis, Dyskinesia, Eye pain, Facial pain, Fatigue, Gait disturbance, Headache, Loss of personal independence in daily activities, Muscle spasms, Nausea, Neck pain, Pain, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Arthritis (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin Pump
Current Illness: None
Preexisting Conditions: Type 1 Diabetes
Allergies: Sulpha antibiotics, produces rash
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Extreme chills and quaking, despite 3 blankets and two heating pads, occasional jerks of my body -within 7 hours. Lasted 20 hours or more. Fatigue- unable to walk myself to bathroom within 8 hours, lasted two or more days. Very weak. VERY Severe Headache, including facial pain, neck pain, temple pain and eye sockets , stared 7 hrs, lasted two days Severe nausea, I actually thought of food poisoning (but it wasn''t). Approx. onset 9 hours. Very painful body aches and muscle spasms throughout my body but especially my Back, underarms, legs, feet. Approx. onset 7 hours. lasted 48 to 60 hour Diabetic Ketoacidosis approx 30 hours after. Wasn''t able to eat, blood sugar remained in the 150 to 180 area. Managed to eat 2 TBsp of applesauce to reduce ketones, (which worked) Fatigue unable to work until 5 days later.


VAERS ID: 1290285 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, Unevaluable event
SMQs:, Medication errors (narrow)

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

Write-up: Received Janssen as a second dose, should have received a Moderna


VAERS ID: 1291584 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Oropharyngeal pain, Pain in extremity, Taste disorder
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210501883

Write-up: LEFT HAND FEELING LIKE HAMMER HIT IT; NASTY TASTE IN MOUTH; THROAT PAIN; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. The batch number was not reported. Per procedure, no follow-up will be requested for this case. On 30-APR-2021, the subject experienced left hand feeling like hammer hit it, nasty taste in mouth and throat pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the left hand feeling like hammer hit it, nasty taste in mouth and throat pain was not reported. This report was non-serious.


VAERS ID: 1291592 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Vermont  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Injection site haemorrhage, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210504237

Write-up: BRUISE AT THE INJECTION SITE; SORE ARM; INJECTION SITE BLEEDING; This spontaneous report received from a pharmacist concerned a 73 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 205A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-APR-2021, the subject experienced injection site bleeding. On an unspecified date, the subject experienced bruise at the injection site, and sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from injection site bleeding, and the outcome of sore arm and bruise at the injection site was not reported. This report was non-serious.


VAERS ID: 1291599 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Accidental exposure to product, Off label use, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210506787

Write-up: OFF LABEL USE; ACCIDENTAL EXPOSURE TO PRODUCT; PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE; .This spontaneous report received from a health care professional concerned a 17 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 203A21A expiry: 23-JUN-2021) dose was not reported, administered on 30-APR-2021 12:03 for prophylactic vaccination. No concomitant medications were reported. On 30-APR-2021, the subject experienced accidental exposure to product. On 30-APR-2021, the subject experienced product administered to subject of inappropriate age. On an unspecified date, the subject experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the off label use, accidental exposure to product and product administered to patient of inappropriate age was not reported. This report was non-serious.


VAERS ID: 1292635 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-03
Onset:2021-04-30
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

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

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

Write-up: She developed a DVT <4 weeks after receiving the vaccine (first became symptomatic 4/30). She has a potential alternative cause in that she was taking oral estrogen but no other provoking factor.


VAERS ID: 1292859 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-30
Onset:2021-04-30
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown.
Current Illness: Diabetes, HTN, Thyroid
Preexisting Conditions: Diabetes, HTN, Thyroid
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient called. States that ?she received the J&J COVID vaccine on 03/30/2021 and that she developed a rash on her leg month after she got the vaccine.? Patient states that now she has a rash on her arm. Denies any other issues. Patient is under the care of Dr for Diabetes, HTN and Thyroid issues. Patient states that she has F/U appt with Dr on 05/25/2021. Advise patient to contact Dr office to notify her about issues with rash. VAERS report completed.


VAERS ID: 1293920 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Pain, Pain in extremity, Pyrexia, Respiratory tract congestion, Sleep disorder, Thirst, Tremor
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Started to get tired and thirsty the evening of the 30th a few hours after the vaccine. Went to bed around 10:30 and woke up about 3 hours later at 1:30. Had chills and was shaking when I got up. Could not really fall back asleep. Chills turned into a fever. That morning I started to get a headache. I sounded congested at one point, but no runny nose. I also had body and joint aches. I took Excedrin three times that day. Once in the morning, once in the afternoon, once before bed. I used zquil to sleep a little bit in the afternoon and again at night. I woke up Sunday and felt completely fine except for my arm still being sore.


VAERS ID: 1294044 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Mississippi  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eye pain, Muscle spasms, Musculoskeletal chest pain, Pain
SMQs:, Dystonia (broad), Glaucoma (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no underline health problems.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210507028

Write-up: SEVERE BODY ACHES ON LEFT SIDE; MUSCLE SPASMS ON LEFT SIDE LEG EYE ARM AND CRAMPING ON RIGHT SIDE; PRESSURE BEHIND LEFT EYE; CRAMPING AND RIB PAIN ON RIGHT SIDE; This spontaneous report received from a patient via a company representative concerned a 52 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no underline health problems. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 2021, the subject experienced pressure behind left eye. On 2021, the subject experienced cramping and rib pain on right side. On 30-APR-2021, the subject experienced severe body aches on left side. On 30-APR-2021, the subject experienced muscle spasms on left side leg eye arm and cramping on right side. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from severe body aches on left side, muscle spasms on left side leg eye arm and cramping on right side, pressure behind left eye, and cramping and rib pain on right side. This report was non-serious.


VAERS ID: 1294457 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Ear discomfort, Fatigue, Headache, Nasal congestion, Oropharyngeal pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D, Spironolactone, Escitalopram
Current Illness: none
Preexisting Conditions: Heart murmur, high cholesterol
Allergies: none
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The first 48 hours I experienced chills, fever, sweating, vomiting, severe headache, and body aches. Then 2 days later I experienced severe congestion, sore throat, fatigue, coughing and plugged ears.


VAERS ID: 1294824 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-30
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210508319

Write-up: BAD RASH ALL OVER HER BODY; This spontaneous report received from a consumer concerned an 86 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 30-APR-2021, the subject experienced bad rash all over her body. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from bad rash all over her body. This report was non-serious.


VAERS ID: 1269674 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-26
Onset:2021-04-29
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site erythema, Injection site pruritus, Injection site urticaria, Injection site warmth, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: Common cold 3 weeks before, allergies
Preexisting Conditions: Allergies
Allergies: Lactose intolerant
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache 24 hrs later Full body ache 24hors later for 24 hours Large red welt ?covid arm) around injection site, itchy, hot to the touch


VAERS ID: 1269798 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chills, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Sulpha and Ampecillin
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Slight fever, severe chills with shakes That tighten the whole body. Talk 2 alka-sheltzer plus cold and flu effervescent tablets. Waiting on results.


VAERS ID: 1269800 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-22
Onset:2021-04-29
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Hard lump, itchy skin at injection site


VAERS ID: 1269807 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Dyspnoea, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Shortness of breath, cough, nausea


VAERS ID: 1269829 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Chills developed around midnight, fever at the time of chills 98.8F, later in the night 102.5. Still ongoing at 4am 04/29/21. Slight frontal headache and sore injection site.


VAERS ID: 1270026 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / SYR

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

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

Write-up: Tinnitus left ear


VAERS ID: 1270092 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-27
Onset:2021-04-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dysphagia, Ear pain, Nasal congestion, Oropharyngeal pain, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen and sore throat. Difficulty swallowing Congestion, pain in ears, and mild cough


VAERS ID: 1270525 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Headache, chills, feeling very tired, muscle aches, nausea. Woke up shaking very hard and couldn''t breathe much, was able to get breathing under control and stop the shaking.


VAERS ID: 1270542 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient received the J&J Covid-19 vaccine then fainted approximately 5 minutes later. Patient came to immediately and was conscious by the time the pharmacist reached the patient. Patient was ok other than having a sore head from when he fell. We provided the patient water and continued to monitor for an additional amount of time for a total of 30 minutes. Patient denied needing anything else such as juice. Patient was okay after and when asked if there was anyone that he could contact to drive with, he said he was okay to drive after.


VAERS ID: 1270724 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Blood pressure increased, Blood test normal, Cataract, Computerised tomogram normal, Dizziness, Fatigue, Head discomfort, Headache, Impaired driving ability, Loss of personal independence in daily activities, Poor quality sleep, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypertension (narrow), Lens disorders (narrow), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Work and CAT Scan at Emergency Room, they found nothing that would be causing my symptoms
CDC Split Type:

Write-up: The Headache/Pressure is there in the morning, and I feel fatigued, like I really didn''t get any rest in the night., And the headache/pressure stays with me all day., But I don''t believe it wakes me in the night, I did developed blurry vision, but only in one eye (right)., I went to Eye doctor, and they said it appeared a cataract had developed since the last visit. but the blurry vision has somewhat improved with reduction of the blood pressure., as far a dizziness., I would not feel comfortable going out and flying a plane since the covid vaccine shot, so I''d say I am a little unstable on my feet right now.....


VAERS ID: 1270816 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

Administered by: School       Purchased by: ?
Symptoms: Incorrect dose administered, Incorrect product formulation administered
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED JANSSEN ON 4/29/21. WHILE IT WAS BEING REPORTED INTO TENNIIS THERE WAS PREVIOUS DOCUMENTATION OF PFIZER 0.3 ML ON 4/9/2021 AT HOSPITAL.


VAERS ID: 1270901 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Throwing up blood


VAERS ID: 1271178 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Patient said he had a stomach bug 2 weeks before vaccination.
Preexisting Conditions: Diabetes
Allergies: Patient listed none of the immunization administration form, but said penicillin when asked before vaccination.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called and complained of a sore throat.


VAERS ID: 1271277 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient started tearing about 3 minutes after received the vaccine. Her face and lips turned really pale and fainted on pharmacist''s arms for 30 seconds. She wore up but still pretty confused. WE gave her water. She stayed in pharmacy with her mom for about 40 minutes and went home.


VAERS ID: 1271387 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-05
Onset:2021-04-29
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

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

Write-up: PATIENT CALLED 4/29/2021 STATING THAT HIS DR DID A BLOOD WORK AFTER 5 WEEKS AND TOLD HIM THAT HE DOESNT HAVE ANY ANTIBODIES AGANIST THE COVID.


VAERS ID: 1271427 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: Patient complained of feeling dizzy getting worse with time. Paramedics on site, assisted and assessed patient. Patient felt better and walked out with significant other.


VAERS ID: 1271469 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site haemorrhage, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient reports they had "done the same thing" and passed out after getting a vaccination "for school."
Other Medications:
Current Illness:
Preexisting Conditions: History of passing out when receiving injections
Allergies:
Diagnostic Lab Data: Patient declined VS. RR 16 at time they left observation.
CDC Split Type:

Write-up: Patient received vaccination in their right arm. Patient looked at injection site and saw a drop of blood, then lost consciousness in the chair. They were held upright by the nurse who administered the vaccination. Patient regained consciousness after several seconds and was transferred to the cot. Ice pack applied to patient''s head due to warm observation area. Patient declined VS, declined a snack, sat with girlfriend and requested to leave at 1420.


VAERS ID: 1271914 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol, cyclobenzaprine, ferrous sulfate
Current Illness: No acute illnesses
Preexisting Conditions: Hypertension, Hyperlipidemia, Intellectual Disability
Allergies: NKA
Diagnostic Lab Data: No adverse reactions noted at time of report - reporting duplicate vaccine administration.
CDC Split Type:

Write-up: Patient reported to clinic today for Covid Vaccination and denied having had previous vaccination. After the administration of her vaccine and upon entry to the EMAR it was realized that she had already obtained a J&J vaccine on 4/9/2021. Upon reviewing her medical record she was given a J&J Vaccine from lot #201A21A in her Left Deltiod IM by our staff at an off-site community vaccination clinic on 4/9/2021. She completed paperwork for the first vaccination under one name and upon presentation today completed paperwork under a different name. She was contacted and advised that she had received a duplicate dose when only 1 dose is recommended. Upon being contacted she did state that she now remembered getting the first vaccine. She was advised to report to the clinic or ER with any concerning adverse reactions.


VAERS ID: 1272016 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 5 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fear of injection
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: she states this happens with needles (shots and bloodwork)
Other Medications: buspar, hydroxyzine, singulair, zoloft,
Current Illness:
Preexisting Conditions:
Allergies: macrolides
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient began feeling faint after a couple of minutes. She states she always has this reaction to needles (vaccines and bloodwork). I had her lay down and put her feet up. She was given a cold cloth. She is used to this so knew that she just needed to lay down and be still for a few minutes. It was about 5 minutes and she felt like sitting up. She sat up for a few minutes and felt fine. She then went to the chair and was back to her normal self. After 15 more minutes of waiting she stated that she felt fine: back to normal. She is an employee so went back to work and will let us know if there are any more issues. She states there usually isn''t after she starts feeling better.


VAERS ID: 1272083 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: patient fainted about 5 min. after receiving the shot. Hit her head on the floor, was immediately awake, alert. Paramedics checked her out and said she was fine.


VAERS ID: 1272089 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Feeling hot, Hyperhidrosis, Hypoaesthesia, Malaise, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: patient was administered vaccine as per EUA/standin order. Approx 30 seconds after the vaccine was injected, the patient who was seated,stated she didnt feel well, fainted and slumped forward in chair. RPH who administered shot was able to catch her, keep her from further injury. Approx 10 seconds later, she came to and was disoriented. RPH explained where she wasand what had occured. She complained of nausea, feeling hot and sweaty and numbness in fingers. 911 was called, and while waiting for EMTs to arrive she stated that she had had some similar reaction during a previous blood draw. EMT arrived and transported her to local ER


VAERS ID: 1272508 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Dyspnoea, Paraesthesia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, Multivitamin, Metamucil
Current Illness: Pulled Muscle on 4/19/21 resulting in abdominal pain, Recent Rx for antibiotics and anti-inflammatory medication (unable to provide info)
Preexisting Conditions: Hyperlipidemia
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient reported acute onset of diffuse tingling sensation , light-headed, with cold sweats, blurred vision, and acute complaints of shortness of breath within 9 mins of injection. Shortness of breath was immediate after administration. VS at 11:30 AM T97.4, HR 60, RR 16 BP 88/58 O2 87- rechecked at 95--lungs CTAB Reports a controlled 1600 cal/day diet, OJ and gummy snack given. Patient encouraged to push PO fluids and focused respirations. O2 stabilized at 94-95% on RA VS rechecked at 12:15 PM 96.9 Tympanic, HR 58, RR 16 even and unlabored, BP 98/72 O2 97% Reported feeling better and with appetite, was able to walk around parking lot for several mins to make sure he felt ok to independently leave and opted to depart. A&O x 3. Insight and judgement intact.


VAERS ID: 1272619 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: Fatigue Injection site soreness (2nd time experiencing this symptom. The first was 24 hours after 2nd vaccination) I am almost 4 months out from my second dose. I experienced a soreness and tenderness to the touch of the vaccination site in my right upper arm. I have also experienced intermittent joint pain.


VAERS ID: 1272621 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-24
Onset:2021-04-29
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Deafness unilateral, Ear pain, Eustachian tube dysfunction
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 75mcg Bupropion hcl xl 300 mg Vitamin D Pregablin 75mg Metformin hcl 500mg
Current Illness:
Preexisting Conditions: Fyrbrmoagia Pcos
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loss hearing in left ear and right ear pain. Eustachiam tube dysfunction in both ears.


VAERS ID: 1272627 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-27
Onset:2021-04-29
   Days after vaccination:367
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A NNS QUA / UNK - / -

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

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

Write-up: Continued soreness and red hot area around the injection site


VAERS ID: 1272631 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Fever, chills, fatigue, headache, body ache


VAERS ID: 1272633 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: Vomiting, diarrhea, chills, nausea, possible fever 19 hours after vaccination Lasting 2 hours Fatigue after the above for 12 hours


VAERS ID: 1272637 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-21
Onset:2021-04-29
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site rash, Pain in extremity, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D; Fish oil; Hair, Skin and Nails
Current Illness: None
Preexisting Conditions: None
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy Red rash/welt around injection site 8 days after shot. Applying hydrocortisone to help alleviate itch. Had sore arm first few days after shot, but rash is new today.


VAERS ID: 1272640 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

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

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

Write-up: Client received first dose COVID vaccine @ 1:52 pm. Client complained of dizziness and headache @2:15pm. Client helped to zero-gravity chair, given some water to drink. Client denied shortness of breath. Client denied any allergies, not taking medications, her son reports she''s had high blood pressure before. Blood pressure @ 2:25pm is 170/115, heart rate 86, respirations 16, O2 sat 98 %. Blood pressure 162/98, pulse 78, respirations 16 @ 2:33pm. Client reports head ache and dizziness present but lessened @ 2:40pm, blood pressure 155/98, pulse 81, respirations 18. Client states she wants to go home @ 2:47pm, instructed to follow up with primary care and when to call 911. Client left observation area with son, able to walk with steady gait.


VAERS ID: 1272651 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Multiple Vitamins Calcium Supplement Baby Aspirin Vitamin C Hydrochlorothiazide Atenolol Losartan Atorvastatin
Current Illness: None
Preexisting Conditions: Type 2 Diabetes High Blood Pressure
Allergies: Lisinopril
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Muscle soreness in shot area


VAERS ID: 1272652 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-01
Onset:2021-04-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta, magnesium supplements, digestive enzymes
Current Illness: N/A
Preexisting Conditions: Fibromyalgia
Allergies: Bactrum
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Itchy red lump about 2 inches in diameter appeared a week after injection. It is very hard to the touch and noticeably raised. Online search says it is ?Covid arm?.


VAERS ID: 1272655 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil Vitamin D3 Zinc and Vitamin C Metformin Citrucel Iron
Current Illness: Diabetes, asthma
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm sore Low grade fever Chills Rashes on both thighs - moved from upper thigh to side of knees. This lasted for about an hour


VAERS ID: 1272659 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Cold sweat, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Client received COVID vaccine @ 3:45pm. Client in observation area, reported having "cold sweats" to EMT staff @ 3:55pm. EMT staff provided client with water, attempted to assist client to zero-gravity chair. Client became unresponsive @3:58pm. Client became responsive @4:01pm, transferred over to cot with assistance, with legs raised. Client able to speak, denies shortness of breath, reports "anxiety with injections and anything going in to my body". Vital signs @ 4:06pm, BP 102/58, P 87, RR 12, O2 sat 97%. Client continued with observation, provided with water. Vital signs @ 4:14, BP 104/60, Pulse 82, RR 12. Client reports he feels much beter, able to sit up in chair. Client advised to follow up with primary care, client reports he will call parents for ride home. Client left observation area @ 4:30pm, walking with steady gait.


VAERS ID: 1272661 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-05
Onset:2021-04-29
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

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

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

Write-up: Acute DVT


VAERS ID: 1273010 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fainted after vaccine (not sure which one)
Other Medications: NONE KNOWN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt light headed and dizzy and passed out briefly following administration of vaccine. Patient had history of passing out during vaccination and blood draws. Patient felt sweaty and turned white. His color returned after a minute, I talked to his mother who was there during the incident. Did not eat or drink the morning of vaccine. I checked his pulse and blood pressure and it was 129/72 and pulse of 78. We gave him some water and orange juice. He felt much better. Then his mom bought him some muffins. He sat and ate for about 30 minutes and left feeling back to normal.


VAERS ID: 1273036 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Confusional state, Flushing, Heart rate irregular, Hyperhidrosis, Hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Chills-Mild, Systemic: Confusion-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Severe, Additional Details: Pt experienced syncope and had a blood pressure reading of 70/40 and a pulse of 44. EMT was called and pt resolved to blood pressure of 105/65 and a pulse of 55. Pt was chose not to go to hospital after filing consent with EMT, he was then pickd up by a coworker and will return for his car later. Pt noted to have a history of low BP in the past but has not see a MD recently and was advised to follow up with new pcp.


VAERS ID: 1273044 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe


VAERS ID: 1273045 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Dizziness, Flushing, Hyperhidrosis, Hypertension, Hypotension, Nausea, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Tachycardia-Medium, Additional Details: Loss of hearing for a few minutes. EMTs came to store monitored pt and BP for additional 15-20 mins. BP increased to over 100. PT had water, crackers and chocolate. Pt felt fine and refused to be taken by ambulance but had a friend pick her up. I explained situation to friend and pt was told to take it easy for the rest of the day.


VAERS ID: 1273049 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: Approximately 10-12mins after the J&J shot was administered, the patient got our attention to let us know he wasn''t feeling well and might faint. I quickly tended to him as he slowly passed out. I craddled his head to make sure he did not hit it on the countertop. Pateint was seated. After approximately 30 second the patient started to come to. We gave him some water, took his bp, had him wait 30mins and took his bp again before he left with his wife.


VAERS ID: 1273058 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Additional Details: Pateint fainted within 5 minutes of receiving the vaccine. 911 was called and responded but he had quickly come to. He felt better within 10 minutes but the paramedics examined him anyway. He left of his own accord.


VAERS ID: 1273065 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Syncope, 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), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Weakness-Mild


VAERS ID: 1273071 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Medium, Additional Details: immediately after vaccination patient became dizzy, started sweating, was flushed and naseaus. rested for about 40 minutes and felt better


VAERS ID: 1273073 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hypotension, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Weakness-Medium, Additional Details: per patient she often experience hypotension, weakness, nausea after injection. She recovered within the hour


VAERS ID: 1273076 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Injection site pain, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Medium, Additional Details: this patient has had similar events with all vaccines administered in the past. he has even had a similar event at work recently due to a cut on his hand.


VAERS ID: 1273080 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Hyperhidrosis, Muscle twitching, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lacinopril, meloxicam
Current Illness: none
Preexisting Conditions: high blood pressure, allergies
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever of 102, body aches, muscle twitching and shaking, extreme sweating, started approx. 10pm, fever broke approx 7am, still having muscle twitching and body aches


VAERS ID: 1273083 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Eye swelling, Injection site erythema, Injection site pain, Mouth swelling, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Right upper eyelid bruise-Mild, Additional Details: patient came and said he woke up with right upper eyelid bruise and not hurting. I advised him to monitor and if getting worse , he need to go to emergency or urgent care


VAERS ID: 1273084 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient has history of fainting with all vaccines. Once receiving vaccine, passed out for 10 seconds and regained consciousness. Vitals were monitored, patient was fine and left after 30mins


VAERS ID: 1273117 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Nausea, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Nausea-Medium, Systemic: Vomiting-Severe


VAERS ID: 1273154 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

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

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

Write-up: Muscle pain, headaches, fever.


VAERS ID: 1273189 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Injection site vesicles
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, wheat, egg, dairy, meat
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Blister at injection site, dizziness today (2 days later). I have not sought treatment yet.


VAERS ID: 1273195 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Fear of injection, Immediate post-injection reaction
SMQs:, Accidents and injuries (narrow), Hypersensitivity (narrow)

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

Write-up: Patient vaccinated at 10am. Patient immediately slumped over in chair and was guided to the floor. Patient was able to site up and was assisted to chair. Patient reported that she has a great fear of needles and that she did not eat prior to vaccination. Patient given granola bar and juice. Patient vitals remained within normal limits. No injuries sustained. Patient observed for 30 minutes and released after improved. No other significant concerns noted.


VAERS ID: 1273212 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-13
Onset:2021-04-29
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood potassium decreased, Blood test normal, Chills, Computerised tomogram normal, Facial paresis, Head discomfort, Headache, Hemiparesis, Hypoaesthesia, Hypoaesthesia oral, Magnetic resonance imaging, Muscle spasms, Pain in extremity, Palpitations, Paraesthesia, Pharyngeal hypoaesthesia, Tremor, Ultrasound Doppler normal
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Hypokalaemia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Catscan 4/29 Leg ultrasound 4/29 MRI 4/30 blood work 4/29 4/30
CDC Split Type:

Write-up: On and off headaches since vaccine. 4/28 right calf pain/ cramping, 4/29 11am quick onset severe pressure headache followed by left side face, arm, and leg numbness/tingling/weakness. Within 1 or 2 minutes heart felt like it was racing combined with body shaking/shivering. Ambulance to the hospital by 11:45am, and she was treated with tPA Alteplese after a CATscan came back negative. Symptoms improved over a few hours. I am writing this 23 hours after the ambulance transport and patient continues to have outside and inside mouth numbness and throat numbness all on left side. Blood work hass been normal except low potassium, leg ultrasounds negative. MRI results pending. Patient is still hospitalized as of 10am on 4/30.


VAERS ID: 1273244 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Patient vaccinated at 11:50am. Patient reported itchy throat at 12:10pm. Patient administered Benadryl 25mg. Also given juice and granola bar. Patient reported improvement 10 minutes later. Patient vitals remained within normal limits. Patient observed for 30 minutes. Patient released following reported symptoms diminished. Patient instructed to go to ED for further evaluation if throat swelling occurs after leaving clinic.


VAERS ID: 1273449 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: pt reported feeling hot and lightheaded - 3-5 minutes later, she became unresponsive - I administered one dose of epinephrine, she came to about 3 seconds later, and stayed stable until the EMTs arrived.


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