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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)

This is page 81 out of 1,889

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VAERS ID: 1212306 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Underage for vaccine. Patient only 16 years old.


VAERS ID: 1212324 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein normal, Chest pain, Electrocardiogram normal, Fibrin D dimer normal, Painful respiration, Troponin I normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 4/13/21 Normal EKG results in office. Bloodwork: D-DIMER <0.27 (normal) TROPONIN I <0.015 (normal range) HSCRP 1.94mg/L
CDC Split Type:

Write-up: Received shot on Wednesday, woke up on Saturday with chest pain when taking deep breaths. Continued to be in pain for most of the day while breathing


VAERS ID: 1212363 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 underage for vaccine


VAERS ID: 1212380 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Chills, Nausea, Pyrexia, Sinus headache, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Vomited, ran a fever and chills, sweated through multiple pairs of clothes in the first 24hrs. 2nd 24hrs had sinus headache, chest pain, and nausea. 5 days later still experiencing nausea and joint pain.


VAERS ID: 1212387 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 underage for vaccine


VAERS ID: 1212423 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-25
Onset:2021-04-10
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180525 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Pulmonary embolism, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: R femur fx with ORIF, anemia, ribs fxs, colon ca, HTN
Preexisting Conditions: HTN,OA, weakness,Hyperlipidemia
Allergies: Amlodipine, Lisinopril, Torsemide, NSAIDs
Diagnostic Lab Data: CT scan showed small P.E.
CDC Split Type:

Write-up: Respiratory distress, sent resident to Emergency room ; CT scan done showed a small Pulmonary EMbolism.


VAERS ID: 1212440 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

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

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

Write-up: Adverse side effects began approximately seven hours after receiving the Johnson & Johnson JANSSEN vaccine. Side effects included: Extreme chills, fever (approximately 99.5F), headache, muscle aches, and fatigue. Side effects lasted approximately 26 hours.


VAERS ID: 1212463 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-03
Onset:2021-04-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Capillary fragility, Cognitive disorder, Feeling cold, Hypoaesthesia, Skin discolouration
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (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: Sodium Alendronate, Estrogen, Progesterone, Testosterone, IC Thyroid, NAC, Selenium, Vit C, Condroitin/Glucosamine, Zinc, Vit D3, Vit E, Vit A, Cholesteroff, Aspirin (low dose), Salmon Oil, Calcium, Magnesium.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Thumb on right hand becomes numb, turns white with apparent loss of blood circulation, and becomes cold. Since April 10, 2021, this has occurred 3 or 4 times without any identifiable cause evident. On April 10, however, the numbness occurred a few hours after a capillary broke and discolored the thumb. Though a capillary break in the fingers is not uncommon, the numbness is a new occurrence. It is not debilitating, though it is disturbing in that it appears my thumb is dying.The numbness dissipates in about an hour. I am not diabetic. In 2002, I did have a mild transient ischemic attack. During the week following the vaccination, cognitive processing was slowed remarkably but has returned to normal.


VAERS ID: 1212684 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-28
Onset:2021-04-10
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Burning sensation, C-reactive protein normal, Double stranded DNA antibody, Full blood count, Haemoglobin decreased, Injection site rash, Laboratory test normal, Magnetic resonance imaging spinal normal, Metabolic function test, Platelet count normal, Pregnancy test urine negative, Rash, Rash erythematous, Rash papular, Red blood cell sedimentation rate increased, Rheumatoid factor negative, SARS-CoV-2 test negative, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Famotidine; Allegra
Current Illness: Clinical URI and sinus infection symptoms in the days immediately following vaccination; sinus infxn was treated w/ abx by PCP
Preexisting Conditions: uterine prolapse, GERD
Allergies: Penicillin, rash
Diagnostic Lab Data: MRI L-spine (4/14/21): unremarkable. Some degenerative changes. ?1mm nodule associated w/ cauda equina near L1-L2 nerve roots, of unclear clinical significance. Urine pregnancy: negative ESR: 26 (4/14/21) CRP: <0.5 (4/14/21) SARS-COV2 (4/13/21) negative CHEM/BMP: unremarkable CBC: hgb 11.1, wbc 6.9, plt 265 dsDNA: negative RF: negative
CDC Split Type:

Write-up: 42 y/o F with a history of uterine prolapse, GERD who is presenting with low back pain x4-5 days, about 2 weeks after receiving the Moderna vaccine on 3/28; she also developed a raised patchy erythematous rash on her L deltoid (site of vaccine injection) a few days prior to onset of the pain. Symptoms began Saturday, 4/10; pt was helping her mother around her house; was not straining excessively; however, later that day had a sudden burning sensation in her lower-mid back, which has since been recurring in paroxysms. At times it spreads into the posterior thighs but not into the feet; sometimes also spreads upward into the upper back and just below the chin. In between attacks, there is no pain or numbness. There has never been weakness. No urinary/bowel incontinence or saddle anesthesia; sphincter tone was normal. NIF/FVC normal -60, 2.3L. Paroxysmal pain controlled w/ 600mg gabapentin q8h since being hospitalized. There has been no development or progression or symptoms, still only pain and normal neurologic and physical exam.


VAERS ID: 1212715 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin-D, Biotin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound revealed a blood clot in my right calf.
CDC Split Type:

Write-up: Developed pain in right calf and hamstring. No improvement over the next few days. Went to Vein specialist and they performed an ultrasound. A blood clot was found in my right calf.


VAERS ID: 1212737 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Chills, body aches, nausea, headache, tired beginning 7 hours after the vaccination and last 30 hours. I did not seek treatment. After 30 hours the symptoms had largely subsided other than a minor headache. Within 48 hours the headache was also gone.


VAERS ID: 1212804 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Skin burning sensation
SMQs:, Peripheral neuropathy (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: SULFA
Diagnostic Lab Data:
CDC Split Type:

Write-up: ALOPECIA RESULTING IN COMPLETE HAIR LOSS ON HEAD OCCURRING APPROXIMATELY 4 DAYS AFTER RECEIVING THE VACCINE. PATIENT ALSO REPORTS BURNING SENSATION ON SCALP.


VAERS ID: 1212844 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus infection 6 weeks prior to vaccination, treated with Augmentin x 10 days (course completed weeks prior to vaccination)
Preexisting Conditions: IgA deficiency (complete) and IgG deficiency (severe)
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, Fevers, Painful Itchy Rash, Muscle aches and pains, Chest "stitch"


VAERS ID: 1212918 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / -

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

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

Write-up: Rash and welts on right arm and neck. Using over the counter medicine for itching.


VAERS ID: 1212948 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A2A / UNK RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (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:
Current Illness:
Preexisting Conditions: Heart attack 4yrs ago,chronic back pain, long term opioid use.
Allergies: Chantix
Diagnostic Lab Data: None
CDC Split Type:

Write-up: EXTREME muscle aches and fatigue. Started the next morning. Time and rest have been the only thing that is working. Still ongoing. Doing better, just not back to "normal "


VAERS ID: 1212991 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       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: Patients guardian falsified DOB when registering for vaccination, stating the minor''s DOB was 11/19/2002. Guardian, consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB is 11/19/2003 which made the vaccine a contraindication. No known adverse reactions noted.


VAERS ID: 1213024 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glipizide 10mg , metformin 1000mg
Current Illness: none
Preexisting Conditions: diabetes, high blood pressure, depression , renal insufficiency
Allergies: penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Call rec''d from pt; she wants to report a reaction to the J & J vaccine which she got this past Saturday 4/10 at 10am; her symptoms began that night at 9pm , primarily nausea and vomiting. she could not keep anything down, finally she remembered a past txment from her childhood, pepto bismol and milk; ( she had IBS as a child); her sxs persisted for about 3 days, finally on Wednesday she felt better and has been tolerating a bland diet; she is better now; pt feels that there is a strong correlation between her diabetes and the vaccine; she is asking that this be reported via the VAERS system; pt did not experience anaphylaxis nor rashes/urticaria, nor any classic blood clot sxs; rn


VAERS ID: 1213036 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-04-10
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Blood glucose increased, Computerised tomogram abnormal, Electrocardiogram normal, Haematuria, Haemoglobin decreased, Haemoptysis, Hypertension, Pain, Pain in extremity, Peripheral swelling, SARS-CoV-2 test negative, Ultrasound Doppler, Urine analysis abnormal, Urine electrolytes normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin, azelastine nasal spray, escitalopram, ibuprofen, levETIRAcetam, MVI, nitroGLYCERIN, pantoprazole
Current Illness: 3/9/21: CV LEFT HEART CATHETERIZATION, CORONARY ANGIOGRAM
Preexisting Conditions: ascending aortic aneurysm (Aug 2020); DVT; pseudoseizures; GERD; thrombocytopenia; tobacco, marijuana and cocaine use; mitral and tricuspid regurgitation; MRSA; bipolar; ADHD; aortic stenosis; CAD; heart valve disorder; dysrhythmia; asthma; seizures; brain cyst; hiatal hernia; pulmonary nodules; epilepsy; migraine; anxiety/depression; schizoaffective disorder;
Allergies: aztreonam, bee venom, carbapenems, ceclor, cephalosporins, depakote, penicillins, pineapple
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine 3.24.21. Had been incarcerated / in prison system until 4.7.21. Complex past medical history. 4.10.21: Went to ED on 4.10.21 - for hematuria. CHIEF COMPLAINT: BLOOD IN URINE (patient reports hematuria an hour prior to arrival along with spitting up a large clot (hemoptysis). denies rectal bleeding at this time. denies being on a blood thinner. c/o back pain starting a few hours ago. HX aortic aneurysm and scheduled to get surgery in a few weeks. )Urinalysis returned showing moderate amount of blood was 73 RBCs. Patient did not have frank hematuria on specimen. Patient''s laboratory work otherwise remains unremarkable. Electrolytes within normal limits. Patient has a stable hemoglobin of 13.8. CT scan showed evidence of acute aortic dissection. There were scattered faint ground-glass opacities along the right upper lobe as well as left upper lobe. COVID-19 testing was added on after results. At this time I do not have a great explanation for the patient''s hematuria. I did instructed to follow up with Urology for further evaluation of this. He is hemodynamically stable I do not believe further testing is warranted at this time. Return precautions were discussed including urinary retention, large volume bleeding or any other concerning symptoms. He voiced understanding of this and was discharged stable condition. He was provided a work note as he is on probation and it is for her of his hospitalization at this time. 4.13.21: Went to ED on 4.13.21: CHIEF COMPLAINT: LEG PAIN (pt c.o. right leg swelling/pain that started 3 days ago; had johnson&johnson vaccine on 3/24 and is concerned for blood clots; supposed to have surgery at the end of the month; recently seen for blood in urine; c.o. generalized body aches)42-year-old male presents with right calf pain and reported swelling. On presentation patient is well-appearing and nontoxic, afebrile, hypertensive 134/113 with otherwise normal vital signs. On exam, the patient has no swelling in the bilateral lower extremities, he does have very mild tenderness to palpation in the right posterior proximal calf just below the knee. Remainder of physical examination is otherwise unremarkable. Given history of blood clot and reported right calf pain, right lower extremity duplex venous ultrasound ordered to evaluate for DVT. EKG was obtained on arrival, and showed normal sinus rhythm with no evidence of ST segment elevated for depression, no dysrhythmia, no comparison when compared with prior EKG from July 2019. Right lower extremity ultrasound showed no evidence of DVT. I shared results of the workup with the patient and told him that there is no indication for further workup or treatment at this time. I recommended Tylenol or Motrin as needed for right leg pain. I recommended compression stockings as needed for right leg swelling. I encouraged him to follow up with all specialists physicians as previously scheduled and with his primary care physician as needed. Office visit 4.14.21: Subjective: a 42 yr.. male evaluated with a video visit on 4/14/2021 Currently he complains of headache, hot/cold flashes (no fever), nasal congestion, and Bilat ear pain. R leg is swollen. The symptoms have been present for 2 day(s). Was incarcerated - has been out for about week. He denies a history of chills and fevers He has tried acetaminophen, Flonase for his symptoms. Sick Contacts: none known History is provided by patient There is history of asthma or recurrent respiratory infections. Went to the ER yesterday and 4/10 Had his J&J vaccine: 3/24 COVID19: negative 4/10


VAERS ID: 1213054 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test, Myalgia, Polycythaemia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: DO NOT HAVE EXACT DATES
CDC Split Type:

Write-up: PATIENT EXPERIENCED "HORRIBLE MUSCLE ACHES AND PAINS" SHE CONTACTED DR AND THEY RAN SOME BLOOD TESTS AND TOLD HER SHE HAD "THICK BLOOD" SO SHE STARTED TAKING ASPIRIN LOW DOSE DAILY AND SHE SAID THE PAIN RESOLVED BUT SHE HAD ANOTHER BLOOD TEST ON 04/15 THAT SHE DOES NOT KNOW THE RESULTS OF YET


VAERS ID: 1213142 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808892 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gaze palsy, Pain
SMQs:, Ocular motility disorders (narrow)

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

Write-up: Patient reported a headache to me in the temple and body aches. I advised her to get with her Dr. She saw a provider at the urgent care and was evaluated and provided medication.


VAERS ID: 1213170 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Pruritus, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR Lithium Clonidine Montelukast
Current Illness: None
Preexisting Conditions: bipolar asthma allergies insomnia ADHD
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt reports headache, fatigue and rash beginning 3 days after the injection. He notes the rash to his upper chest and back (maculo-papular), described as itchy and not radiating to other areas of the body. The rash has not gotten better or worse and remains today. He also notes "discoloration" (which was not seen on exam by this NP) to the right lower shin.


VAERS ID: 1213264 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-04-02
Onset:2021-04-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pruritus, Rash erythematous, Rash papular
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Raised, red rash (hives?) periodically appearing all over body. Very itchy, not painful. Individual flare ups subside after several hours if not itched or irritated. First noticed 8 days after vaccination. Continue to appear on day 13 (today) but less frequent.


VAERS ID: 1213265 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Fungal infection, Migraine, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Opportunistic infections (broad)

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

Write-up: Beginning the evening of 04/10/2021 i had developed a migraine, chills, and body aches. This continued throughout the day on 04/11/2021 as well as extreme fatigue. The morning of 04/12/2021, i was feeling fine for the most part outside of having the chills. Around 2:00 p.m. on 04/12/2021, i began to get bodyaches again as well as an accompanying migraine and was now experiencing some nausea and had begun to develop a yeast infection. On 04/13/2021, most symptoms had resolved outside of the continuing yeast infection. No symptoms were present on the morning of 04/14/2021, other than the yeast infection. The evening of 04/14/2021 i began to develop symptoms again in the form of a migraine, body aches, and nausea. The morning of 04/15/2021, i woke up with these same symptoms, but also had the chills again and was very fatigued.


VAERS ID: 1213281 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Patients guardian falsified DOB when registering for vaccination, stating the minor''s DOB was 11/25/2002. Guardian consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB is 11/25/2003 which made the vaccine a contraindication. No known adverse reactions noted.


VAERS ID: 1213378 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Dizziness,Fainted and a quick tremor for couple minutes


VAERS ID: 1213533 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: dose given to a 17 year old


VAERS ID: 1213997 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-31
Onset:2021-04-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / N/A RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Headache, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Aleve, ibuprofen, Maca root supplement
Current Illness: None
Preexisting Conditions: History of leukemia-remission since 2009
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within two weeks-leg pain, chest pain, abdominal cramps, headache and nausea


VAERS ID: 1214076 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Pain, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: HEADACHE, NAUSEA, VOMITING, BODY ACHES, RASH


VAERS ID: 1214101 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Pain in extremity, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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

Write-up: Patient received vaccination without noted reaction. On 04/10/2021 patient was transported to hospital via ambulance c/o shortness of breath. Patient was diagnosed with pneumonia. Patient refused admission and returned home with prescriptions for inhalers, steroids, and antibiotics. Patient claims on 02 at home prior to event. Patient also c/o left leg pain (unspecified) but has not sought medical care. Patient treated at Hospital. Patient was advised to follow with her PCP for leg pain.


VAERS ID: 1214127 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Embolic stroke, Mechanical ventilation, Mental status changes
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: calcioum vit D furosemide vit C metoprolol lisinopril pantoprazole
Current Illness:
Preexisting Conditions: hypertension dementia CVA multiple sclerosis CAD CABG
Allergies: vancomycin amlodipine bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: New embolic strokes requiring hospitalization and mechanical ventilation due to mental status. New lower and upper DVT, unable to anticoagulated due to new strokes. Symptoms started acutely on day of admission, 4 days after vaccination


VAERS ID: 1214130 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling cold, Headache, Night sweats, Palpitations, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular 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: Klonipin 1 mg 2x a day Lexapro 30 mg Melatonin 10 mg at bed
Current Illness: Digestive issues
Preexisting Conditions: Sojgrens syndrome ITP A-fib IBS-C
Allergies: Penicillin IV contrast
Diagnostic Lab Data: Spoke with pcp office several times
CDC Split Type:

Write-up: Intense headache with no relief from ibuprofen and Tylenol (still have it) Acid reflux. No relief from over the counter medication (still have it) Dizziness (still occurring) Heart palpitations Cold chills Night sweats ( continue to today) When any part of my skin is touched anywhere in my body it feels like pins and needles Fever on the first day over 103 ( subsided within 24 hours)


VAERS ID: 1214320 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A - / SYR

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

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

Write-up: Fever, aching, only lasted the night.


VAERS ID: 1214345 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysarthria, Loss of consciousness, Somnolence
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), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Nurse administered vaccine, within 1-2 mins the patient became drowsy, drooping head forward, closing eyes, and slurring speech. Patient lost consciousness and slumped into chair, EMS on site, administered IV fluids and transported to hospital.


VAERS ID: 1214363 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Electrocardiogram, Hyperhidrosis, Nausea, Seizure
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Per patient statement once with Influenza vaccine approx 3 years ago
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 12-Lead EKG performed by EMS
CDC Split Type:

Write-up: After receiving vaccination recipient was driving into observation when seizure like activity was observed. Car was put into park, scene safe. Chief Medical Officer on scene. EMS called to scene. Recipient c/o nausea and appeared diaphoretic. Vitals @1009 - BP 122/76 - O2 99% r/a - P48- RR 16. 12 Lead EKG completed by EMS reviewed by Drs. It was recommended by Dr. that recipient be transported to Hospital for further evaluation. Recipient refused transport against medical advice. Recipient signed refusal of transport with EMS and had a friend pick him up. Vitals @ 1045 - P113/68 - O2 95% r/a - P49 - RR 16 AAOx4 per EMS.


VAERS ID: 1214372 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none reported
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient rolled to side, after he regained consciousness, moved to a reclining chair, Vitals taken and juice given PO. Held him for about 25 min. Orthostatic BP taken. patient stated he felt fine, vitals good, no dizziness prior to discharge home.


VAERS ID: 1214391 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Patient has experienced severe headaches since her injection on 4/9/21. She was treated by her primary care provider.


VAERS ID: 1214398 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-05
Onset:2021-04-10
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Rhinorrhoea, SARS-CoV-2 test positive, Sinus operation, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None day of vaccination, prior to that unknown
Preexisting Conditions: none listed
Allergies: None listed
Diagnostic Lab Data: 3/5/2021 SARS-CoV-2 negative 3/7/2021 testing done prior to flight home, client stated it is negative 4/13/2021 SARS-CoV-2 positive
CDC Split Type: 1111309

Write-up: On 03/05/2021 patient tested negative for SARS-CoV-2 and received the Johnson & Johnson (Janseen) vaccination prior her flight on 3/8/2021. She was fully vaccinated as of 3/19/2021. On 4/1/2021 and 4/2/2021 she met in a small office for an extended time with one other person, both wearing masks. Person stated he was not feeling well. On 4/7/2021 patient tested negative for SARS-CoV-2 prior her return flight. On 4/9/2021 she learned person she met with had tested positive for SARS-CoV-2. 4/10/2021 patient flew home. Later that same night, patient began to have what she described as allergy symptoms of throat drainage, runny nose and sneezing. She tested positive for SARS-CoV-2 on 4/13/2021. Her sample was sent to Department of Health and Environment for whole genome sequencing. Results have come back confirming her positive result and as of the time of this report no genome results are back.


VAERS ID: 1214417 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Computerised tomogram head normal, Dizziness, Full blood count normal, Headache, Metabolic function test, X-ray normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfur drugs
Diagnostic Lab Data: CMP, CBC were normal. Just x-ray was normal. CT scan of the head without contrast was normal.
CDC Split Type:

Write-up: Patient experience headache, dizziness, with elevation in blood pressure.


VAERS ID: 1214452 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Hypoaesthesia, Oropharyngeal pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, low grade fever, sore throat, numbness in my left arm, tired, frailness


VAERS ID: 1214470 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Full body hives


VAERS ID: 1214524 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-17
Onset:2021-04-10
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood magnesium abnormal, Blood thyroid stimulating hormone, Cardiac monitoring abnormal, Cardiac stress test, Chest X-ray normal, Differential white blood cell count, Dizziness, Dyspnoea, Echocardiogram abnormal, Electrocardiogram normal, Fibrin D dimer, Full blood count normal, Lipids, Liver function test normal, Metabolic function test, Paraesthesia, Prohormone brain natriuretic peptide, Troponin I, Urine analysis normal, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: magnesium, hawthorn berry, nattokinase, policosanol, vitamin C, omega 3, lutein, biotin, lion''s mane mushroom.
Current Illness: none
Preexisting Conditions: I contracted Lyme disease 6 years ago while working in Maryland.
Allergies: lactose intolerant, mild reaction to sulfa based antibiotics
Diagnostic Lab Data: Results are that they did not find anything really out of whack to cause the symptoms.My heart beats jumped up to 190 and they put me on beta blockers for now.
CDC Split Type:

Write-up: I was going up and down a ladder while painting the eves. I bent over trying to catch my breath with my hands on my knees.My wife who is a nurse said that''snot normal and we need to go to the hospital. While driving there I felt a tingling in my entire body and thought I was going to pass out. We got to the hospital and they hooked me up to a monitor. My heart beats were super low and jumping all over the place throwing PVC''s. It showed my rate going down to 28 beats and then back up to 60 and down again.It was all over the board. They decided to keep me overnight for observation and tests. Saturday night they drew blood twice to run tests and took urine samples. Here is the list of tests, doctor and dates: NM STRESS TEST 1/2 (RADIOLOGY) , MD Apr 12, 2021 Imaging NM STRESS TEST 2/2 (CARDIOLOGY) , MD Apr 12, 2021 Imaging ECHOCARDIOGRAM 2D COMPLETE W OR WO CONTRAST PRN , DO Apr 11, 2021 The result is abnormalLab LIPID PANEL , DO Apr 11, 2021 Lab CBC , DO Apr 11, 2021 Lab MAGNESIUM , DO Apr 11, 2021 The result is abnormalLab BASIC METABOLIC PANEL , DO Apr 11, 2021 Lab TROPONIN I , DO Apr 11, 2021 Lab TSH , DO Apr 11, 2021 The result is abnormalLab HEPATIC FUNCTION PANEL , DO Apr 10, 2021 Lab URINALYSIS AUTO ONLY , DO Apr 10, 2021 Lab URINALYSIS REFLEX TO MICROSCOPIC-INPATIENT , DO Apr 10, 2021 The result is abnormal Lab D-DIMER,QUANTITATIVE , MD Apr 10, 2021 Imaging XR CHEST 1 VIEW AP PORTABLE , MD Apr 10, 2021 Lab CBC WITH DIFFERENTIAL , MD Apr 10, 2021 The result is abnormalLab BASIC METABOLIC PANEL , MD Apr 10, 2021 Lab TROPONIN I , MD Apr 10, 2021 Lab MAGNESIUM , MD Apr 10, 2021 The result is abnormalLab BNP PRO , MD Apr 10, 2021 Lab CBC WITH DIFFERENTIAL REFLEX MANUAL DIFF , MD Apr 10, 2021 Other type of result ECG 12-LEAD , MD Apr 10, 2021 Results are that they did not find anything really out of whack to cause the symptoms.My heart beats jumped up to 190 and they put me on beta blockers for now.


VAERS ID: 1214631 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dyskinesia, Muscle tightness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Chills, shortly followed by shivering and chattering. The shivering is so intense it essentially renders the patient in a state of involuntary writhing; muscles across the body, even if not in movement, may be tensed to the point of pain. Muscles affected lie in the legs, arms, and torso. An observer might mistake the event for a seizure, though the patient is fully conscious for the duration. The episode lasts only a few minutes; such an episode has only occurred once.


VAERS ID: 1214672 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Crying, Impaired work ability, Irritability, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

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

Write-up: Client reports that she received the vaccine at approx. 11 AM on 04/10/2021. At approx. 2 PM that day, she states that she felt very irritable. Throughout the week she states she felt very "weepy" and emotional along with irritability. Today the client states she has become very shaky. She states it''s "not uncontrollable but I was having trouble holding a pen and using a keyboard, and I had to leave work." Recommended that she call her PCP and report these things to them as well. She voiced understanding.


VAERS ID: 1214714 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Electrocardiogram, Headache, Injection site rash, Injection site reaction, Laboratory test, Rash erythematous, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa 30 mg
Current Illness: None
Preexisting Conditions: None
Allergies: No e
Diagnostic Lab Data: Ekg Cat scan with contrast - head Blood tests All on April 14, 2021
CDC Split Type:

Write-up: Severe headache continuing for 7 days and rash red 2 in circle near vaccine site started on day 5.


VAERS ID: 1214736 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-25
Onset:2021-04-10
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lozartan,100 mg. Metroperol100mg. Chlorthalidone25mg. alfuzocin Hal 10mg
Current Illness: None
Preexisting Conditions: High pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1214820 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Gait disturbance, Pain in extremity, Tenderness, Tendon disorder
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B12, One Daily Mens Health, Potassium, EpiPen, Sildenafil, Gabapentin, HCTZ, Glipizide, Rosuvastatin, Ozempic, Enalapril
Current Illness:
Preexisting Conditions: Diabetes, HTN, High Cholesterol, Colitis, History of DVT, Back pain
Allergies: Ginger, NSAIDs, Metformin, Glucophage
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient began having back pain on Friday but by Saturday was having a hard time walking. Having pain at the left elbow, both shoulders, left knee and left foot. Dr. came in to examine patient as well. Think he is having tendinopathy as pain was not in the joint itself. Patient having pin point tenderness. Denies fever.


VAERS ID: 1214840 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-04-10
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Hypokalaemia, Occult blood positive, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Haemorrhage laboratory terms (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Gastrointestinal haemorrhage (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (narrow)

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

Write-up: N17.9 - AKI (acute kidney injury) R19.5 - Occult blood positive stool E87.6 - Hypokalemia R55 - Syncope


VAERS ID: 1214846 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       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: Sprintec
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin, Sulfa Drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheadness from Day1-present (Day 7). I feel dizzy and lightheaded all the time. Mild headache occurred from Day 1-4.


VAERS ID: 1214863 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Facial spasm, Magnetic resonance imaging head
SMQs:, Dystonia (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: Levothyroxine, Trazadone, Sudafed
Current Illness: No
Preexisting Conditions: Hoshimoto''s Disease
Allergies: Aspartame
Diagnostic Lab Data: Brain MRI, cranial nerve baseline exam
CDC Split Type:

Write-up: Hemifacial Spasms left side started on 4/12 and continued 48 hours until I took a muscle relaxer. Never occurred prior to vaccine


VAERS ID: 1215009 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprintec (birth control)
Current Illness: ear infection treated week before vaccination
Preexisting Conditions:
Allergies: allergic to amoxicillan and gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: About seven hours after vaccination (~5:30pm), felt slight chills. Over about a half hour, they escalated to severe chills and a 101.9 degree fever that lasted through the night. Chills subsided about 3am, but fever remained until following morning and slowly lowered until about noon the day after vaccination. That day, arm soreness increased, with sharp pain when arms raised or pressure applied, and soreness continued until five days after vaccination.


VAERS ID: 1215018 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Small Blisters on my back, 55, fall 2013, Flu vaccine
Other Medications: Allegra D Glucosamine, Turmeric Vitamin C Zinc Clindamycin Levothyroxine
Current Illness: Seasonal Allergies Tooth Infection
Preexisting Conditions: Indoor and outdoor allergies
Allergies: Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day 2 - fever to 100.1, fatigue, aches, headache Day 3 - 5, no fever, fatigue, aches, headache, nausea (less each day) Day 6 - normal


VAERS ID: 1215073 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-10
Onset:2021-04-10
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1082072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Computerised tomogram, Dyspnoea, Incision site pain, Mobility decreased, Pneumonia, Pulmonary thrombosis, Thrombectomy, X-ray
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buspirone, losartan, propranolol, hyoscyamine, B12, tumeric, cetirizine, AZO cranberry, ashwagundha, cbd oil, vitamin d3
Current Illness: high heart rate
Preexisting Conditions: low back pain
Allergies: Shell fish
Diagnostic Lab Data: Medical Test = blood drawn, x rays and CT Scan
CDC Split Type:

Write-up: On 4/10/21 to Urgent Care. Found blood clots in my lungs and Pneumonia, Clots removed at Hospital on 4/11/21. Hospitalized until 4/13/21. Treatment - blood thinners (enoxaparin, heprin and steroids), azithromycin, Advair disk, albuterol, Spiriva, Symbicort Outcome: Still trouble breathing, slow moving and sore from the incesion.


VAERS ID: 1215076 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-05
Onset:2021-04-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dyspnoea, Fatigue, Headache
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: ON 4/5/2021 RECEIVED THE UNEVENTFUL VACCINATION SHOT. ON 4/10/2021 ABOUT MIDNIGHT STARTED TO COUGH VERY STRONGLY WITH A VIRTUALLY CONTINUOUS COUGHING SPELL FOR THE NEXT TWO HOURS. STOPPED THE COUGHING WITH ROBITUSSIN. SIMULTANEOUSLY , HAD SHORTNESS OF BREATH, EXTREME FATIGUE AND HEADACHES.


VAERS ID: 1215158 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 developed a blood clot


VAERS ID: 1215159 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Portal vein thrombosis
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow)

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

Write-up: acute SMV/IMV/portal vein thrombus


VAERS ID: 1215454 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Dyspnoea, Pain in extremity, Pulmonary embolism, Ultrasound scan abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine
Current Illness: no
Preexisting Conditions: htn, prediabetes
Allergies: none
Diagnostic Lab Data: CT positive for pulmonary embolism
CDC Split Type:

Write-up: Pt had Johnsons and Johnsons vaccine Pt presented to the ER with shortness of breath and left leg pain. She had a CT and ultrasound that showed a PE.


VAERS ID: 1215492 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chest pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Severe chest pain started a and led to externally heavy chest feeling, currently in hospital. Evening of vaccine very weak and muscle aches. Within days extreme chest pain, weakness, heavy ness in chest.constant pain and breathing problems


VAERS ID: 1215511 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Hypersomnia, Migraine, Nausea, Sinusitis
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium
Current Illness: None
Preexisting Conditions: EDS type 3, bpd, fragile x
Allergies: Fentynol, remeron, bactrum Dark chocolate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Been sleeping for almost 5 days, nauseous, muscle weakness and exhaustion, rapid onset sinus infection, migraine I can''t get rid of, hot and cold Migraine startig 4/14 as of 6 pm 4/15 not gone.


VAERS ID: 1215867 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: DECISION MAKING: Adverse side effects of Covid-19 Vaccination his presentation is common for adverse effects for vaccination. He does not report any anaphylaxis or thromoemobolitic type reactions. We discussed that him adding in 600 to 800 mg of ibuprofen medication every 6 to 8 hrs to alternate with his Excedrin (caffiene, Tylenol, and ASA) medication every 4 to 6 hrs with food to avoid GI upset. I advised him to incorporate other comfort measures such as a heating pad, rest, fluids such as ginger ale, rest for the next 24 hours and that his symptoms are likely to resolve. If however they worsen he understands that he should be seen in person immediately. I encouraged him to register his symptoms with the CDC so he will have ongoing monitoring of his adverse side effects. He indicated he would do so. 1. Adverse effect of vaccine, initial encounter
CDC Split Type:

Write-up: Pt. is a 44 y.o. male evaluated with a web video visit for evaluation of side effects after undergoing the Janssen Covid-19 vaccine yesterday. He describes having systemic side effects of fever as high as 100.8F, chills, fatigue, body aches, and headache. He underwent the vaccine yesterday at approximately 1045. He relates that he took Excedrin migraine a few hours ago but is not having relief. He would like to know if it okay for him to take any other medications to treat his side effects. He denies any cutaneous, thrombohemolytic, or analphylaxis side effects.


VAERS ID: 1215935 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillin -rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient said later the day of vaccination her hands, feet, eyes, fingers started swelling --NO issues breathing and NO tongue swelling. Patient took benadryl. Following day patient took benadryl again. When she told pharmacist about it they suggested she been seen at an urgent care or hospital, they may want to prescribe steroid treatment. Patient did go to hospital and reported they did put her on steroids.


VAERS ID: 1215991 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / UN

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

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

Write-up: Severe itching and rash lasting 3 days


VAERS ID: 1216056 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Syncope


VAERS ID: 1216078 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-31
Onset:2021-04-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Gait disturbance, Insomnia, Pain in extremity, Pyrexia, Skin warm, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog Insulin Omeprazole Famotidine Glyburide Lisinopril Tolteridone
Current Illness:
Preexisting Conditions: Diabetes Hypertension GERD Acid Ulcer
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Leg Pains Unable to sleep due to pains Hot spots on legs Difficulty walking Fever


VAERS ID: 1216120 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Chills, Influenza like illness, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Flu-like symptoms. High temp, chills, nausea, body aches lasted through the night.


VAERS ID: 1216131 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-04-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Loss of consciousness, Palpitations
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), 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: Depression and anxiety
Allergies:
Diagnostic Lab Data: EKG 4/13/2021 approximately 1:30pm
CDC Split Type:

Write-up: Passed out after stretching once, heart palpitations multiple times, light headedness


VAERS ID: 1216146 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio, Anion gap, Aspartate aminotransferase normal, Basophil count normal, Basophil percentage, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood osmolarity, Blood potassium normal, Blood sodium normal, Blood urea nitrogen/creatinine ratio, Blood urea normal, Carbon dioxide normal, Cerebral venous sinus thrombosis, Chills, Dyspnoea, Eosinophil count normal, Eosinophil percentage, Globulin, Glomerular filtration rate, Haematocrit normal, Haemoglobin normal, Headache, Hyperhidrosis, Lymphocyte count increased, Lymphocyte percentage increased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count increased, Monocyte percentage, Neutrophil count normal, Neutrophil percentage decreased, Pain, Platelet count normal, Protein total normal, Red blood cell count normal, Red cell distribution width normal, Scan with contrast abnormal, Troponin T normal, Venogram abnormal, Vision blurred, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine 75 mcg PO QD Metformin 2000 mg PO QD Multivitamin 1 tab PO QD
Current Illness:
Preexisting Conditions: PCOS Type 2 diabetes
Allergies: Propoxyphene - unknown
Diagnostic Lab Data: EXAM: MRA VENO HEAD W/WO C INDICATION: Other- Note in Reason For Exam FreeText. Worsening headache and blurred vision status post recent Johnson and Johnson vaccine menstruation COMPARISON: None. TECHNIQUE: MR venogram of the head performed without and with 10 cc gadolinium based IV contrast. FINDINGS: There is asymmetric decreased enhancement of the right cavernous sinus as compared to the left (for example sequence 701, image 99). Dural venous sinuses otherwise appear patent. Cortical veins are patent. IMPRESSION: Findings are suspicious for cavernous sinus thrombosis on the right. 4/14/2021 Sodium 140 mmol/L Normal Potassium 4.4 mmol/L Normal Chloride 104 mmol/L Normal CO2 24 mmol/L Normal Anion Gap 12 mmol/L Normal Glucose 90 mg/dL Normal BUN 11 mg/dL Normal Creatinine 0.69 mg/dL Normal Bun/Crea 16 Ratio Normal eGFR 99 mL/min/1.73 m2 NA eGFR 119 mL/min/1.73 m2 NA Calc Osmo 278 Normal ALT 22 International Units/L Normal AST 26 International Units/L Normal Alkaline phosphatase 61 Units/L Normal Bilirubin Total 0.2 mg/dL Normal Total Protein 6.5 gm/dL Normal Albumin 3.7 gm/dL Normal Globulin 2.8 gm/dL Normal Alb/Glob 1.3 NA Calcium 8.6 mg/dL LOW Troponin T w/Courtesy Call <0.01 ng/mL Normal WBC 9.58 thous/uL Normal RBC 5.37 mill/uL Normal Hgb 15.4 gm/dL Normal Hct 45.8 % Normal MCV 85.3 fl Normal MCH 28.7 pg Normal MCHC 33.6 gm/dL Normal Platelet 289 thous/uL Normal MPV 10.7 fl Normal RDW-CV 13.4 % Normal Neut % 46.3 % NA Lymph % 42.7 % NA Mono % 8.2 % NA Eos % 2.1 % NA Baso % 0.5 % NA Neut # 4.43 thous/uL Normal Lymph # 4.09 thous/uL HI Mono # 0.79 thous/uL HI Eos # 0.20 thous/uL Normal Baso # 0.05 thous/uL Normal IG % 0.2 % NA IG Abs 0.02 thous/uL Normal
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Patient received Janssen vaccine 4/9/2021. Patient presented to ED 4/14/2021. Patient is a very pleasant 32-year-old female, with past medical history significant for taking bromocriptine for prolactin issues as well as metformin for type 2 diabetes, presents to the emergency department for evaluation of continued headache over the last 1 week. Patient also reports chills, sweats, body aches ever since receiving the Johnson and Johnson coronavirus vaccination 1 week ago. The headache started after receiving the vaccination and has been continuing ever since. It does not fluctuate in intensity. It is caused her blurred vision and difficulty focusing. No tinnitus or hearing loss. No slurred speech, vomiting, numbness or weakness or tingling to the extremities or any facial droop. No history of strokes or aneurysms. She is not on blood thinning medication at all. No upper nor lower extremity swelling or redness. No abdominal pain, nausea, vomiting or diarrhea. She reports the continued subtle shortness of breath and body aches since the vaccination as well. No rapid heart rate, long flights, long car rides, surgeries nor oral contraceptive use. Patient started on heparin drip. Neurologist recommended transferring patient to higher level of care. emergency department physician is willing to accept the patient at their facility. Patient transferred to the facility.


VAERS ID: 1216241 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Diarrhoea, Dyspnoea, Dyspnoea exertional, Fatigue, Fibrin D dimer normal, Pain
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (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: D-dimer on 4/15 was negative
CDC Split Type:

Write-up: Report she got the vaccine on 4/10/21 and started having achiness, fatigue shortly after. 3 days later pt developed diarrhea (watery), cough, SOB. Reports SOB worse with exertion, talking.


VAERS ID: 1216289 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / -

Administered by: School       Purchased by: ?
Symptoms: Chills, Headache, Muscle spasms, Pain, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (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: Adderall, collagen vitamins
Current Illness: None applicable
Preexisting Conditions: Asthma, eczema, ADHD
Allergies: Pollen, dust, pet dander, trees, grass, bananas, papaya, kiwi
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The night I got the vaccine I felt like my body had been put through a cheese grater and I had been half-heartedly put back together. I had a severe fever, chills, headache, muscle spasms in my neck, and whole body aches. This was over the course of 7 hours where I woke up every couple of minutes and thought I was dying. I feel better now though.


VAERS ID: 1216316 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-30
Onset:2021-04-10
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / -

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

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

Write-up: Chest pains for one day. Then headache and lightheaded


VAERS ID: 1216370 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syringe issue, Underdose
SMQs:, Medication errors (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: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unknown amount of vaccine was squirted out at the luer-lock junction between the syringe and needle at initial vaccination on 4/10/2021. Per agency Interim Clinical Considerations provided when we contacted the Janssen Medical Information Center, for doses less than half (or unknown), we readministered another vaccination to the patient on 4/12/2021.


VAERS ID: 1216488 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Hypoaesthesia oral, Pain in jaw, Tinnitus
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Osteonecrosis (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: Numbness and tingling in extremities from flu shots about 10 years ago
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulpha
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed serious tinnitus in my left ear, numb sensations in my left check and gums and sore jaw. These symptoms continue. Also had strong soreness in last shoulder and numbness in left arm that has mostly subsided. The shot was in my left arm.


VAERS ID: 1216509 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Pustule, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: A few pox on arm and ribs. At first itchy, then painful to the touch.


VAERS ID: 1216590 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Collagen Peptides, prenatal vitamin, probiotics
Current Illness: none
Preexisting Conditions: none
Allergies: Food - allergic to shrimp (causes hives on face and jawline that resolve quickly after taking an antihistamine). Medications - allergic to Vicodin (induces vomiting)
Diagnostic Lab Data: No tests performed, only physical examination.
CDC Split Type:

Write-up: 1st outbreak of full body hives occurred early the morning on April 11th. Hives on neck, chest, back, head and scalp. Hives burned and were extremely itchy and uncomfortable, unable to sleep. Urgent Care provider prescribed prednisone 20 mg tablet, cimetidine 200 mg tablet and cetirizine 10 mg tablet and hives went away. 2nd outbreak of full body hives occurred early morning on April 13th. 2nd outbreak worse than the 1st outbreak with hives on face, neck, head/scalp, chest, torso, back, groin, arms and legs. Again, hives burned and were extremely itchy and uncomfortable, unable to sleep. Saw Urgent care provider and dermatologist on April 13th and dermatologist prescribed topical steroid creams, OTC Allegra 2x a day and Hydroxyzine HCL 25mg to take before bedtime. Significant improvement of hives the next morning. As of April 15th I am continuing the prescribed treatment and hives have greatly improved but as still have light markings where the hives were.


VAERS ID: 1216599 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abnormal dreams, Blepharospasm, Dysstasia, Fatigue, Feeling of body temperature change, Insomnia, Myalgia, Pain, Somnolence, Tenderness, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Extreme fatigue onset after 2-3 days, difficulty staying awake/alert. Blurry vision & twitching eyes. Have difficulty being able to focus vision on close text & objects, and I''m a photographer who works through a camera and views a computer screen every day, so has been affecting my business. Have tried basic eye drops, but that doesn''t help. Leg and upper/lower back muscles are extremely sore, even to the touch, especially upper leg muscles (and have not done any strenuous activities in the past week), and it''s been painful to stand up or get out of my vehicle most of the time since my 1st shot exactly one week ago. Have also been having very bizarre dreams every night, and trouble sleeping, as well as bouts of hot/cold flashes every day. No cough, runny nose, headache, or other cold symptoms. Have never felt like this before, regret getting this vaccine, and am not sure I''ll take the 2nd one, unfortunately. I have two close friends who had the same shot, and whom didn''t even feel safe driving for 2+ weeks because of their similar reactions with fatigue and brain fog.


VAERS ID: 1216607 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Fatigue
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, multi vitamins
Current Illness: None
Preexisting Conditions: IBS, mild asthma, dust mites allergy
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, fatigue appeared few days after vaccination, but then disappeared after day 5. However stomach pain appeared and persist past one week after vaccination. Cannot tell if this is from vaccine or not, but reporting about it anyway.


VAERS ID: 1216615 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Fatigue, Headache, Myalgia, Nausea, Neck pain, Somnolence, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Fatigue,severe muscle pains, headache,nausea,dizziness,drowsiness, loss of appetite. Increased heart rate,exhaustion,extreme pain at base of neck


VAERS ID: 1216631 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspepsia, Fatigue, Migraine, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 50mg, Fluoxetine 20mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe extreme migraine, nausea, heartburn, tiredness, body aches, chills


VAERS ID: 1216632 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-31
Onset:2021-04-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Rash erythematous
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid arm or vaccine arm 10 days after vaccine red rash for 6 days now


VAERS ID: 1216634 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Dyspnoea, Fatigue, Headache, Hemiparesis, Hypoaesthesia, Magnetic resonance imaging, Pain, Pain in extremity, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seizure disorder
Allergies: None
Diagnostic Lab Data: Ct 4/9/21 MRI with contrast 4/9/21
CDC Split Type:

Write-up: I experienced dizziness, a severe headache pain radiating from the right arm, Weakness and numbness on the right side of my body, fatigue and shortness of breath.


VAERS ID: 1216635 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Computerised tomogram head, Dizziness, Dyspnoea, Headache, Nausea, Physical examination
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: ROS: General: No fatigue, fevers/chills, malaise. + insomnia Eyes: No eye pain, eye discharge, visual changes Ears: No ear pain, hearing changes Nose/throat: No nasal congestion, so
CDC Split Type:

Write-up: Chest pain to left side 5days ago. Started having some headache and feeling like passing out yesterday. Some shortness of breaths and nausea present. Patient presents to ED with 3 days of headache, chest pain and nausea. She had the J&J vaccine 5 days ago. She felt like she was going to pass out.


VAERS ID: 1216658 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Breast mass, Breast pain, Breast swelling, Erythema, Pain, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Lipodystrophy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I had my first dose of Covid vaccine, Pfizer 30ug at 3:40pm on 4/8/21. 1 day after my first dose I started have low fever(98.8-99.2f). 2 days after my first dose of Covid vaccine my left breast start being painful and start whole body ache. 4 days after first dose my left breast start having an half egg size painful touchable lump with red, warm and swelling. I started taking Acetaminophen 10 mg bid. 4 days on 4/11 till today after first dose for both pain control and reducing body temperature. I used to have granulomatous mastitis on my right breast which is self limited and I had not have this problem for one year. Although the mechanism is still unclear but some theory of this disease is more like an autoimmune problem. I doubt somehow this vaccine has too strong immunogenicity, or at least which is too strong for me. I was getting Pfizer which is 30ug I think. Possibility: 1 Too large dose for my body size (120 lb) 2 Some adjuvant in this Pfizer vaccine induces too strong cellular immune response which may initiate or help for some none Covid specific antibody production, unfortunately for some patients who have autoimmune disease are triggered by this vaccine then they may start producing autoimmune antibody which start self attacking.


VAERS ID: 1216773 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: 16 year old patient received Moderna vaccine instead of Pfizer. There were extra doses at end of day and we were calling to get additional people in for vaccination. We used the "golden ticket" process, so cars were not marked as Pfizer or Moderna and all vaccines were on one lane. Registration identified the patient as needing Pfizer. During vaccination, Moderna was administered. Pt should get 2nd dose of Moderna per CDC. Communicated with mother on error and plan.


VAERS ID: 1216814 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergy.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420344

Write-up: VOMITING; CHILLS; NAUSEA; This spontaneous report received from a patient concerned a 34 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced vomiting. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from nausea, vomiting, and chills. This report was non-serious.


VAERS ID: 1216840 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Low weight
Preexisting Conditions: Medical History/Concurrent Conditions: Premature baby
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420502

Write-up: BODY ACHE; DIZZINESS; FEVER; HEADACHE; DIFFICULTY SLEEPING; This spontaneous report received from a parent concerned a 19 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included premature baby, and concurrent conditions included asthma, and very thin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 13:45 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced difficulty sleeping. On 11-APR-2021, the subject experienced headache. On 11-APR-2021, the subject experienced fever. On 11-APR-2021, the subject experienced body ache. On 11-APR-2021, the subject experienced dizziness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, fever, and body ache, and the outcome of dizziness and difficulty sleeping was not reported. This report was non-serious.


VAERS ID: 1216847 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420514

Write-up: CHILLS; HEADACHE; NAUSEA; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced headache. On 10-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, nausea and chills was not reported. This report was non-serious.


VAERS ID: 1216849 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420528

Write-up: HEADACHE; This spontaneous report received from a consumer 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: unknown) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch number was not reported. The company was unable to perform follow up to request batch/lot numbers. No concomitant medications were reported. The company is unable to perform follow up to request batch number . On APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of headache was not reported. This report was non-serious.


VAERS ID: 1216869 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Test Date: 20210410; Test Name: Body temperature; Result Unstructured Data: 100.6 (unit not reported); Test Date: 20210410; Test Name: Body temperature; Result Unstructured Data: 97 (unit not reported)
CDC Split Type: USJNJFOC20210420632

Write-up: CHILLS; SORE ARM; FEVER; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 15:00 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced sore arm. On 10-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 97 (unit not reported), 100.6 (unit not reported). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, and fever, and the outcome of sore arm was not reported. This report was non-serious.


VAERS ID: 1216875 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: West Virginia  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A214 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Diarrhoea, 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? 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: Test Date: 20210410; Test Name: Body temperature; Result Unstructured Data: 101.5 F
CDC Split Type: USJNJFOC20210420655

Write-up: DIARRHEA; CHILLS; FEVER; This spontaneous report received from a health care professional concerned a 57 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, batch number: 042A214, expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced diarrhea. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.5 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea, and was recovering from fever, and chills. This report was non-serious.


VAERS ID: 1216882 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL 10 MG
Current Illness: Alcohol use; Anxiety; Hypertension; Marijuana abuse
Preexisting Conditions: Comments: no known allergies and no history of drug abuse/ Illicit drug use
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420680

Write-up: METALLIC TASTE; This spontaneous report received from a patient concerned a 30 year old. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension, anxiety, alcohol use occasionally once per month or once every 3 months, and smoke marijuana twice daily for anxiety, and other pre-existing medical conditions included no known allergies and no history of drug abuse/ illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. Concomitant medications included lisinopril for hypertension. On 10-APR-2021, the subject experienced metallic taste. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from metallic taste on 10-APR-2021. This report was non-serious.


VAERS ID: 1216887 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420707

Write-up: MUSCLE PAIN; FEVER; 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: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced muscle pain. On 10-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle pain, and fever. This report was non-serious.


VAERS ID: 1216913 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Throat tightness, Tongue dry
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420779

Write-up: TIGHTNESS IN THROAT; DRY TONGUE; DRY COUGH; This spontaneous report received from a patient 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 10-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 10-APR-2021, the subject experienced tightness in throat. On 10-APR-2021, the subject experienced dry tongue. On 10-APR-2021, the subject experienced dry cough. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tightness in throat, dry tongue, and dry cough. This report was non-serious.


VAERS ID: 1216916 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Chills, Headache, Hypoaesthesia, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? 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: 202104; Test Name: Body temperature; Result Unstructured Data: 100 F; Test Date: 202104; Test Name: Body temperature; Result Unstructured Data: 103.3 F; Test Date: 202104; Test Name: Body temperature; Result Unstructured Data: 102.3 F
CDC Split Type: USJNJFOC20210420802

Write-up: BODY ACHES; HANDS NUMB; CHILLS AND SHAKING/SHIVERING; VERY ACHY JOINTS; FEVER; HEADACHE; This spontaneous report received from a consumer concerned a 45 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: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 14:15 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: Body temperature (NR: not provided) 100 F, 102.3 F, 103.3 F. On 10-APR-2021, the subject experienced body aches. On 10-APR-2021, the subject experienced hands numb. On 10-APR-2021, the subject experienced chills and shaking/shivering. On 10-APR-2021, the subject experienced very achy joints. On 10-APR-2021, the subject experienced fever. On 10-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from chills and shaking/shivering, and hands numb, and had not recovered from very achy joints, body aches, fever, and headache. This report was non-serious.


VAERS ID: 1216922 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Nasopharyngitis
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: Thyroid disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420841

Write-up: COLD; HEADACHE; This spontaneous report received from a patient concerned a 41 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included thyroid problems. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802068, expiry: 10-APR-2021) dose was not reported, administered on 10-APR-2021 10:50 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced cold. On 10-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, and cold. This report was non-serious.


VAERS ID: 1216929 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420917

Write-up: FEELING TERRIBLE; CHILLS; MUSCLE ACHE; HEADACHES; FEVER; This spontaneous report received from a parent concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced feeling terrible. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced muscle ache. On 10-APR-2021, the subject experienced headaches. On 10-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the muscle ache, headaches, chills, fever and feeling terrible was not reported. This report was non-serious.


VAERS ID: 1216938 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Gastrooesophageal reflux disease; Comments: The patient had no known allergies
Allergies:
Diagnostic Lab Data: Test Date: 20210410; Test Name: Body temperature; Result Unstructured Data: 102 F
CDC Split Type: USJNJFOC20210421004

Write-up: MUSCLE SPASMS; NAUSEA; FEVER; HEADACHE; This spontaneous report received from a consumer concerned a 23 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included severe acid reflux, and other pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 18:30 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced muscle spasms. On 10-APR-2021, the subject experienced nausea. On 10-APR-2021, the subject experienced fever. On 10-APR-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 102 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from nausea, and had not recovered from fever, muscle spasms, and headache. This report was non-serious.


VAERS ID: 1216943 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210421053

Write-up: ACHES; CHILLS; TIREDNESS; This spontaneous report received from a patient via a company representative concerned a 61 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, batch number: 042A21A, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced aches. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from aches, chills, and tiredness on 11-APR-2021. This report was non-serious.


VAERS ID: 1216945 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Dizziness, Hot flush, Hypertension, Oxygen saturation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: patient had no known medication and food allergy.
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: elevated; Test Name: Oxygen saturation; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210421083

Write-up: Dizzy; HOT FLUSHES FACIAL; ELEVATED BLOOD PRESSURE; This spontaneous report received from a pharmacist concerned a 40 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no known medication and food allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 043A21A, and batch number: 043A21A expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 14:03 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021 14:15, the subject experienced dizzy. On 10-APR-2021 14:15, the subject experienced hot flushes facial. On 10-APR-2021 14:15, the subject experienced elevated blood pressure. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) elevated, and Oxygen saturation (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from elevated blood pressure, had not recovered from dizzy, and the outcome of hot flushes facial was not reported. This report was non-serious.


VAERS ID: 1216948 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Pain, Pyrexia, Tremor
SMQs:, 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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210421122

Write-up: BODY ACHES; SHAKING; CHILLS; FEVER; This spontaneous report received from a parent 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, batch number: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced body aches. On 10-APR-2021, the subject experienced shaking. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, fever, body aches, and shaking. This report was non-serious.


VAERS ID: 1216970 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210410; Test Name: Body temperature; Result Unstructured Data: 101.2 F; Test Date: 20210411; Test Name: Body temperature; Result Unstructured Data: 99.2 F
CDC Split Type: USJNJFOC20210421240

Write-up: JOINTS HURT (ARM, BODY, AND FEET); CHILLS (LIKE SYMPTOMS OF FLU); NAUSEA; FEVER; FEELING ACHY; This spontaneous report received from a patient concerned a 56 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, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, Laboratory data included: Body temperature (NR: not provided) 101.2 F. On 10-APR-2021 17:00, the subject experienced feeling achy. On 10-APR-2021 17:00, the subject experienced chills (like symptoms of flu). On 10-APR-2021 17:00, the subject experienced nausea. On 10-APR-2021 17:00, the subject experienced fever. On 11-APR-2021, the subject experienced joints hurt (arm, body, and feet). Laboratory data included: Body temperature (NR: not provided) 99.2 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nausea on 11-APR-2021, was recovering from fever, and had not recovered from feeling achy, joints hurt (arm, body, and feet), and chills (like symptoms of flu). This report was non-serious.


VAERS ID: 1216972 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Cough, Injection site pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), 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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210410; Test Name: Body temperature; Result Unstructured Data: 102 F
CDC Split Type: USJNJFOC20210421258

Write-up: BODY ACHES; COUGHING OCCASIONALLY; FEVER; PAIN ON INJECTION SITE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced body aches. On 10-APR-2021, the subject experienced coughing occasionally. On 10-APR-2021, the subject experienced fever. On 10-APR-2021, the subject experienced pain on injection site. Laboratory data included: Body temperature (NR: not provided) 102 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, body aches, coughing occasionally and pain on injection site was not reported. This report was non-serious.


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