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

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



Case Details (Reverse Sorted by Onset Date)

This is page 84 out of 1,535

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VAERS ID: 1181616 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Pt complained of light headedness and feeling dizzy


VAERS ID: 1181666 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

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

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

Write-up: Fever of 38.5


VAERS ID: 1181681 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient reported feeling dizzy and experiencing a pre-syncopal episode Patient seen by medical team , given water and stated symptoms later improved Patient refused medical transport and signed AMA form


VAERS ID: 1181695 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK RA / IM

Administered by: School       Purchased by: ?
Symptoms: Immunisation, Incorrect dose administered, Syringe issue
SMQs:, Medication errors (narrow)

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

Write-up: WVU Nursing Student administering vaccine to R delt. Syringe leaked around needle during injection and less than half of vaccine was administered. Full dose administered to L delt per CDC recommendation. Pt monitored for 15 minutes after vaccination.


VAERS ID: 1181705 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt had a headache after vaccination


VAERS ID: 1181713 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / IM

Administered by: School       Purchased by: ?
Symptoms: Immunisation, Incorrect dose administered, Syringe issue
SMQs:, Medication errors (narrow)

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

Write-up: Staff was administering vaccine to L-delt. Syringe leaked around the needle and less than half dose was administered. Full dose administered to R-delt per CDC recommendation. Pt monitored for 15 minutes after vaccination.


VAERS ID: 1181727 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Fluctuance, Headache, Initial insomnia, Pain
SMQs:, Dementia (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Ibuprofen
Current Illness:
Preexisting Conditions: Obesity, Asthma
Allergies: Pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: J&J COVID-19 Vaccine EUA Soreness and aches (around whole body), fatigue, headache, chills - Currently taking ibuprofen to address symptoms. Woke me up in the middle of the night (3:00 AM) and had considerable difficulty going back to sleep. Headache persists through the day, but aches and chills seem to fluctuate/come in waves. Currently at 24 hours from receiving injection at time of writing this report.


VAERS ID: 1181729 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysstasia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)

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

Write-up: Patient experienced light headedness and felt as if she was about to faint. she had to sit down on the floor because she could not stand. This occurred about 5 minutes after administration of the vaccine. prior to receiving the vaccine the patient stated that they have had a history of fainting when she sees needles. patient was offered water for hydration, and given a cold rag and water bottle to put on her face and neck. Patient was advised to sit with her chest down to her thighs. after about fifteen minutes the patient felt better and wanted to go home with her mother


VAERS ID: 1181735 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye movement disorder, Glassy eyes
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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Observer noticed patient eyes glazed , Call pharmacist over - pharmacist spoke with patient, he noticed eyes rolling up and yelled to call 911 -then asked patient her name And where she was - did Not answer - pharmacist administered epi pen. Paramedics arrived


VAERS ID: 1181746 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Fall, Head injury, Skin laceration
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Vestibular disorders (broad)

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

Write-up: Janssen dose given at 11:38am. At 11:45am Patient c/o feeling dizzy while sitting in the chair post vaccine (5 Min Jassen). Patient fell backward onto the ground hitting his head and sustaining a posterior head laceration. Vitals taken B/P 101/52 HR 58 RR 16 SPO2 100% RA..... EKG completed and fluids N/S given. Transferred out to ED


VAERS ID: 1181757 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Vital signs measurement
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: CA134B1001

Write-up: At 0940, RRT was called for a 27 y/o M with complaints of dizziness with diaphoresis. Vitals: BP ? 128/84, HR ? 78, RR ? 18. Vaccinated on the L arm at 0929. No PMH, NKA, only took a Multivitamin today. Head-to-toe assessment completed. He did not eat for the day yet. The vaccination staff encouraged him to eat prior to receiving the vaccination but client declined. During monitoring period, client?s condition improved. Client stated he was okay to drive home and did not feel dizzy anymore. Client was not diaphoretic anymore. Client was educated that if he feels worse at any time, he can call 911 or go to the nearest hospital. Patient departed vaccination clinic at 1000 in stable condition, ambulatory, with breathing even and unlabored.


VAERS ID: 1181769 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), 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: Pt. stated he is not taking any medication.
Current Illness: Pt. stated he is healthy
Preexisting Conditions: Pt. stated he does not have any chronic condition
Allergies: Pt. stated he does not have any allergies
Diagnostic Lab Data: Blood pressure at the time he fainted 154/125 Blood pressure when the 911 arrived (10 min later) 128/92 Blood Sugar
CDC Split Type:

Write-up: Pt. walked to the front of the Pharmacy from the post vaccination waiting area (4 feet) asking for help because he was dizzy. He was sweating and having shortness of breath. Pt. was taken to the seat where he fainted. Pt. was laid on the floor with his legs up in a step. He gained consciousness in less than 1 min. Pt was pale. Pt. was given an alcohol swab to smell. 911 was called. First responders took his blood pressure again and blood sugar. Uncle''s pt. was called and came to the Pharmacy to pick him up to avoid pt. having to drive his car back home.


VAERS ID: 1181777 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Chills, fever, intense body aches


VAERS ID: 1181780 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Myalgia, Pain, Pallor, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (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: Multivitamin, fish oil, melatonin, niacin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Jansen COVID-19 Vaccine EUA 7am, headache down through shoulders, pain at site 9am, severe chills and chattering, white lips pale skin 3pm muscle body aches, 101 fever


VAERS ID: 1181791 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dry mouth, Hyperhidrosis, Immediate post-injection reaction, Motor dysfunction, Muscular weakness, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: when 911 arrived, they measured his pulse, blood pressure, and blood sugar. Everything was normal
CDC Split Type:

Write-up: once the person recieved the vaccine within a minute he felt dizzy, dry mouth, blurred vision, kept sweating he asked for water but he lost control of his muscle and the water spilled on his pants. We called 911, then after about 6 minutes he felt ok even before 911 arrived.


VAERS ID: 1181792 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-01
Onset:2021-04-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 43A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Limb discomfort, Pain, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), 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? No
Previous Vaccinations:
Other Medications: Cymbalta, unithroid, liothyronine
Current Illness: None
Preexisting Conditions: Fibromyalgia, hypothyroid
Allergies: Biaxin
Diagnostic Lab Data: 0
CDC Split Type:

Write-up: Fatigue, dizziness, generalized aches, small headache. Tops of feet painful & throbbing. Also had ligament repair in right hip for which I am going to physical therapy. Three incision sites are throbbing/burning.


VAERS ID: 1181801 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2021A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Cold sweat, Nervousness, Peripheral pulse decreased
SMQs:, 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: Atavan,, Xanax, Clonopin
Current Illness: denies
Preexisting Conditions: anxiety
Allergies: no known allergies
Diagnostic Lab Data: BP 160/98 -Pulse- 82- resp-18- O2 saturation 98%. Medical assessment on site.
CDC Split Type:

Write-up: Clammy skin, thready pulse, shaky, and anxious


VAERS ID: 1181807 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Pain, Paranasal sinus discomfort, Pyrexia, Vomiting
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? 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: N/A
CDC Split Type:

Write-up: Headache, body aches, fever, vomit and nausea, fatigue, sinus pressure. Treatment: extra strength tylenol, sleep, fluids (water/Gatorade)


VAERS ID: 1181820 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Neck pain, Pain in extremity, Sluggishness
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: women''s organic multi-vitamin. Birth control (Junel Fe 1.5/30). Flonase once daily. Generic Claritin once daily. Visine eye drops for allergies. Pataday eye drops for allergies.
Current Illness: Allergies (if those count as illnesses). No other illnesses.
Preexisting Conditions: None.
Allergies: Hydrocodone. Bees.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Painful injection. Localized pain around injection site and general arm soreness. Soreness did not extend beyond arm. Headache morning after. Neck soreness morning after. Heavy fatigue and sluggishness.


VAERS ID: 1181823 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abnormal faeces, Flatulence
SMQs:, Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Torsemide, Tramadol, Senna Plus, Tylenol, Adalat, Coreg, Nitroglycerin patch, Lidocaine 5% patch, Miralax, AREDS 2-PreserVision, Krill Oil, OsteoByFlex
Current Illness: None.
Preexisting Conditions: AFIB, Lung Cancer, HBP, Cronic Constipation, Arthritis, OsteoArthritis, CHF.
Allergies: Allergy: Penicillin. Bad reactions to: Prednisone, Percocet, multiple NSAIDs
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: 3 hours after injection patient had tremendous amount of GI GAS, very odd oder (smell). Buildup of gas came suddenly and was unstoppable. Patient feels better after release of gas and cleanup of bowel movement.


VAERS ID: 1181833 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Feeling cold, Feeling hot, Increased appetite, Peripheral coldness, Pyrexia
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), 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: Multivitamin, calcium with D3, and probiotics
Current Illness: None
Preexisting Conditions: Seronegative Rheumatoid Arthritis , Sijorens Syndrome, and Osteoporosis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: First felt super cold especially feet then super hot and bottoms of feet were burning. Had low grade fever 99.9 took Tylenol now much better but very hungry in the middle of the night


VAERS ID: 1181839 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu Vaccine
Other Medications: HTN Meds and High Cholesterol Meds
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient reported history of adverse reaction to Flu Vaccine in the past and now reporting Shortness of Breath post 15 mins after vaccine administration. Patient transported to local ER for further evaluation.


VAERS ID: 1181852 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-04-05
Onset:2021-04-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary mass, Chills, Headache, Influenza like illness, Lymphadenitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, atorvastatin, fluticasone, glimepiride, ibuprofen, jardiance, metformin, tizanidine, trulicity
Current Illness: Chronic back pain, diabetes mellitus, elevated blood pressure, hyperlipidemia, secondary erectile dysfunction,
Preexisting Conditions: anxiety, asthma, eczema, obesity
Allergies: None
Diagnostic Lab Data: none.
CDC Split Type:

Write-up: 4/5 (Day of vaccine)- slight headache. 4/6- worsening fever, chills, flu- like symptoms, excruciating headache. 4/7: resolving symptoms, but small (grape sized) lump under Right Axilla. 4/8- Lump size of an apple. Contacted the facility. In for examination (internal medicine) (infectious disease): Reactive lymphadenitis. soft, moveable, non-tender, not red/inflamed. recommended ice and tylenol as needed and to contact clinic of not resolving within a week.


VAERS ID: 1181897 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lip swelling, Pruritus
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: SESAME SEEDS
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt c/o of lipe swelling and itching after administration of vaccine


VAERS ID: 1181909 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient reported walking to restroom, feeling dizzy and had pre-syncopal episode witnessed by staff and brought to floor Patient stated symptoms improved Patient seen by medical team and ambulance was called and patient sent to hospital


VAERS ID: 1181940 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / IM

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

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

Write-up: No apparent injury of adverse effect. Vaccine was inadvertently administered to patient below approved age for EUA.


VAERS ID: 1181948 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: The patient experienced dizziness, lightheadedness a few minutes after receiving the vaccine, he also complained of sweating and chills. I gave him some water to drink and mountain dew, and I had him lay on his back for several minutes. The patient said he felt better and more alert after laying on the floor. After 10 minutes, I had him sit back up, he was feeling much improved. After 10 more minutes, he wanted to get a snack before he left. I requested he come back after the snack just to check in on him after he had walked around. The patient left the pharmacy feeling normal again.


VAERS ID: 1181955 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-05
Onset:2021-04-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Dizziness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Light headed was and fainted about 48 hrs after vaccine was administered


VAERS ID: 1182005 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 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? Yes
Hospitalized? No
Previous Vaccinations: Fainted from vaccines in the past
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient fainted 5 minutes after receiving the vaccine


VAERS ID: 1182008 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0421A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Panic attack
SMQs:

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

Write-up: After receiving the vaccine, the patient had a mild panic attack. The patient has a history of panic attacks and the feeling on the vaccine in his arm is what started the attack. The patient laid down for a few minutes and calmed himself down. After about 5 minutes, he was able to sit back up again and was feeling better.


VAERS ID: 1182015 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Heart rate, Heart rate decreased, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Syncope and heart rate 42, sweating


VAERS ID: 1182016 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: The patient became unwell a few minutes after receiving the vaccine, he informed me he threw up, felt dizzy and sweaty. I gave him some water and a cookie. He said he felt better after consuming the cookie. I had him sit in a chair outside my counseling room and to knock if he continued to feel unwell. After 10 minutes, the patient said he was feeling much improved. I had the patient wait another 20 minutes before leaving. The patient left feeling normal again.


VAERS ID: 1182029 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient has had fainting issues in past with vaccinations. About 5 seconds after injection, the patient fainted, fell asleep, started to snore, then had seizure symptoms. After about one minute, the patient woke up and said he was okay. He was observed in the room for 2 hours, given hydration, towels, a pillow, and a fan to keep him comfortable. Signs and symptoms were normal when before he was allowed to leave after 2 hours.


VAERS ID: 1182034 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Emotional distress, Loss of consciousness, Muscle spasms, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (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), 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: Not known
Current Illness: No illnesses
Preexisting Conditions: None
Allergies: None reported by pt.
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt was give vaccine and was not nervous or anxious. About 1 to 2 minutes after receiving the shot pt passed out for about 20 seconds. The technician held the pt up and supported her head and neck while asking pt if she was OK. When pt came to she was happy and said "hi" to the technician. Soon after she laid on the floor and started crying and saying her hands were cramping and in pain. She also stated she was very nauseous and felt like she was going to throw up. Pts husband agreed that we should call an ambulance which we did. When paramedics arrived pt was feeling better and refused a ride to the ER. Pt''s husband took her to the car and drove her to the ER.


VAERS ID: 1182042 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN A43A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fainting
Other Medications: unknown
Current Illness:
Preexisting Conditions: Patient told us after the fact that he had fainted after other injections
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient got light headed and fell -- did not lose conciousness


VAERS ID: 1182045 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eyelid rash, Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had rash on arm, chest, and under eyes, she self administered liquid benadryl 50 mg, and 911 was called, EMS took patient to hospital, patient never had trouble breathing or speaking


VAERS ID: 1182049 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Head injury, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: PATIENT HAD A SEIZURE AND FELL. SHE DID HIT HER HEAD. FALL WAS NOT WITNESSED BY THE RESPONDERS. VITAL SIGNS WERE TAKEN: BP 142/88, PULSE 98, O2 SATS 100%, RESPIRATIONS 20, BLOOD SUGAR LEVEL 84. HELPED PATIENT TO WHEELCHAIR AND SECURED HER TO THE FIRST AID AREA. AMBULANCE WAS CALLED AND SHE WAS TRANSPORTED TO THE ER.


VAERS ID: 1182051 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SERTRALINE 50MG QHS
Current Illness: NONE
Preexisting Conditions: MAJOR DEPRESSIVE DISORDER
Allergies: NO KNOWN OTHER ALLERGIES
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA


VAERS ID: 1182052 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Moaning, Unresponsive to stimuli, Vitreous floaters
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Retinal disorders (narrow), 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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient came in for J&J vaccine. He said he had no history of severe allergic reaction to anything, including meds, food, vaccines or any injections. He said that he did not receive any other vaccine in the past 14 days. According to the patient, he did not have test positive for Covid or was in contact with anyone with Covid for the past 2 weeks. He appeared perfectly fine prior to receiving the vaccine. Once the vaccine was given, within about 5 seconds, he said that he was seeing spots, he closed his eyes and made sounds that were similar to snoring. His neck was completely down on his right side and he almost fell off his chair. I held him so he would not fall off the chair and called for help. A few of the co-workers came to hold him. He was non responsive and my co-workers helped to put his legs on the chair. At point, I gave him an epipen. Once the epipen was given, he opened his eyes in about few seconds and became responsive. The nurses came and took over at this point. I stayed with him and the nurses for a few minutes. The patient was fully responsive and talking by the time I left the nurses and the patient. 911 was activated after the first epipen was given. The patient was then evaluated by EMS and the onsite nurses. The patient was AOx4 with stable vital signs. The patient had orthostatic vital signs taken and were within normal limits. The patient demonstrated that he was able to ambulate with no assistance. The patient signed a refusal for transport to the hospital and was driven home by a colleague. The patient remains in care of that colleague for monitoring. The patient was instructed that if he were to begin feeling the previous symptoms that he is to activate 911 and be seen in a hospital. Patient understood the instructions and went back to his residence.


VAERS ID: 1182060 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ventolin, Lipitor, Symbicort, Depakote, Neurontin, Vistaril, Melatonin, Metformin, Zyprexa, Invega, Paxil, Trazadone, Propanolol.
Current Illness: Pt was hospitalized on 3/25/2021 due to acute respiratory failure caused by accidental overdose on patient''s medications. Pt reports being on a ventilator during her stay.
Preexisting Conditions: Bipolar disorder, schizophrenia, autism, DM type II, COPD, Asthma, HTN, and hypercholesterolemia.
Allergies: Ketorolac, geodon, haldol, seroquel. These medications cause increased anxiety and suicidal ideation for patient - not true allergy.
Diagnostic Lab Data: CT Scan 04/08/2021
CDC Split Type:

Write-up: Pt hospitalized today 04/08/2021 with chest pain and was found to have a pulmonary embolism.


VAERS ID: 1182062 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: The patient became very dizzy and lightheaded, sweaty. I got her some water and had her lie on her back. She said that really helped. After 5 minutes, she sat in the chair again and had some more water. After 10 more minutes, she was feeling much improved. I had her wait 15 more minutes before leaving the pharmacy. The patient left feeling normal again.


VAERS ID: 1182068 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia oral, Peripheral swelling, Swelling face, Swelling of eyelid
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Approximately two hours after receiving Janssen Covid19 vaccine, patient experienced swollen hands, tingly lips, eyes, face. Patient feel better after administer liquid benadryl


VAERS ID: 1182069 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Skin laceration
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), Accidents and injuries (narrow), Hostility/aggression (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out and hit his head on the floor cause a laceration above left eyebrow which needed medical attention at local hospital. Also may have needed a concussion test done.


VAERS ID: 1182072 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hot flush, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HOT FLASH AND VOMITING


VAERS ID: 1182085 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, Injection site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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: Spironolactone 150mg daily, loestrin, daily multivitamin, probiotic, biotin
Current Illness: None
Preexisting Conditions: Seasonal allergies, elevated blood pressure
Allergies: Levaquin, moxifloxacin, thimerosal
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Intermittent sharp pains at injection site starting 2 days after dose. Numbness in left hand and arm starting 3 days after dose, continuing for a couple of hours


VAERS ID: 1182087 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSSEN / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Headache, Injection site pain, Pain, Pyrexia, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (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: none
Current Illness: none
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Woke up at midnight with chills which last approximately 4 hours and restless sleep throughout the night. Woke up at 5am with aches and pains all over, soreness at the injection (upper left arm) and a headache. Took Excedrin at 9am and felt better until around 3 when the aches came back. Took my temperature and was running a slight fever at 99.0 degrees. Took Tylenol extra strength as a fever reducer.


VAERS ID: 1182091 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Patient felt light headed and so layed down on floor. Patient recovered and walked out of facility on own.


VAERS ID: 1182093 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: CA134B1001

Write-up: At 1158, RRT was initiated for a 23 y/o F with c/o of feeling to pass-out, had burry vision, and was diaphoretic. Vitals: BP ? 110/72, HR ? 96, RR ? 14. Vaccinated on the L arm at 1150. Has anxiety, NKA, and did not take any medications today. Head-to-toe assessment completed. During monitoring period, client?s condition improved. By the end of monitoring period, client was in stable condition. Client left vaccination clinic at 1210 in stable condition, ambulatory, breathing even and unlabored, accompanied by her boyfriend. Boyfriend drove client home. Client was not diaphoretic anymore and her vision was normal and clear.


VAERS ID: 1182105 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18089980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Injection site urticaria, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (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: Metoprolol Succinate, aspirin, amlodipine,
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: Augmentin, Erythromycin, hyzaar, lisinopril, bactrim
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Urticaria, of injection site. Left upper arm, left shoulder, left upper back, subjective itch and burn


VAERS ID: 1182132 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Pain, Pyrexia, Restlessness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Woke up in the middle of the night with fever and chills. Work up next morning with headache, body aches, fever, chills, really sore arm. At 11AM, checked temperature, and it was 102; Took extra strenght tylenol and she napped for 3 hours. Took another temp at 1PM, and she was back down to 98.4. As of 5PM, about 24 hours after the shot, she is doing much better and is only experiencing injection sight pain.


VAERS ID: 1182143 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, 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), Accidents and injuries (narrow), 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: THE PATIENT PASSED OUT A FEW MINUTES AFTER RECEIVING THE VACCINE. HE FELL OUT OF HIS CHAIR AND WAS FULLY CONSCIOUS WHEN I CAME TO HIS SIDE A FEW SECONDS LATER. WE HAD THE PATIENT STAY LAYING DOWN AND HE SAID HE FELT COMPLETELY FINE. THE PATIENT DID NOT WANT US TO CALL AN AMBULANCE. AFTER A FEW MINUTES, WE TOOK THE PATIENT TO OUR PRIVATE CONSULATION ROOM AND CONTINUED TO MONITOR HIM FOR AT LEAST 30 MINUTES. THE PATIENT''S MOM ARRIVED AT THE STORE, WE EXPLAINED THE SITUATION, AND THEY LEFT TOGETHER. WE CALLED THE PATIENT A FEW HOURS LATER AND HE WAS DOING FINE.


VAERS ID: 1182146 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient about 3 minutes after receiving vaccine felt light headed, vision blurred, and felt like he was going to black out. Pharmacist had patient get down on floor to bend knees and get them above heart level and he started feeling relief. Patient quickly recovered.


VAERS ID: 1182202 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Patient reported feeling nauseated and dizzy Patient seen by medical team Patient refused medical transport and signed AMA form Patient driven home with spouse


VAERS ID: 1182222 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prebiotics, probiotics, omega 3, magnesium, iron, women''s multivitamin, kurvelo birth control, zafirlukast, bupropion, zyxel
Current Illness: bunionectomy performed on 3/8/2021
Preexisting Conditions: asthma
Allergies: neosporin, season allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after vaccination the vaccination area became red, warm to the touch, and swollen


VAERS ID: 1182261 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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? 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 FAINTED FOR 3-4 MINUTES...CALLED 911..PATIENT WAS TAKEN TO HOSPITAL


VAERS ID: 1182266 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient stated previous reaction to FLU Shot before she knew she was allergic to egg.
Other Medications: UNKNOWN
Current Illness: NONE NOTED ON IMMUNIZATION FORM
Preexisting Conditions: HYPOTHYROIDISM
Allergies: LATEX, TETRACYCLINES, EGGS
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received vaccine at 352pm and was in her waiting period of 15 minutes , came to the window complaining of itchy throat and tingling of face. We moved patient into immunization room and had her sit and called 9-1-1 at 400pm . She was responding and able to talk so we gave her 25mg of liquid benadryl- within 5 minutes she was complaining of itchy and tingling face gave another dose of 25mg benadryl. EMS arrived checked patient out , vitals were ok patient signed a release to go home.


VAERS ID: 1182273 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: PCN, wheat, pineapple, dairy products, cranberries, quinoa, barley, rye, and eggs
Diagnostic Lab Data: None
CDC Split Type: CA134B1001

Write-up: At 1343, RRT was initiated for a 33 y/o F with c/o dizziness, blurry vision, and was diaphoretic. Vitals: BP ? 98/62, HR ? 52, RR ? 19. Vaccinated on the R arm at 1340. No PMH, has multiple allergies (PCN, wheat, pineapple, dairy products, eggs, quinoa, cranberries, barley, and rye), and did not take any medications today. Head-to-toe assessment completed. During monitoring period, client?s condition improved. By the end of monitoring period, client was in stable condition. She was not dizzy anymore, had normal and clear vision, and she was no longer diaphoretic. Client left vaccination clinic at 1425 in stable condition, ambulatory, breathing even and unlabored, accompanied by her husband. Husband drove client home.


VAERS ID: 1182275 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Vertigo
SMQs:, Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Patient reported feeling anxious and sensation of vertigo Patient seen by medical team and refused medical transport and signed AMA form Patient stated symptoms improved


VAERS ID: 1182286 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyskinesia, 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), Dyskinesia (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: seizure history
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient post Johnson and Johnson vaccination and in observation period when EMS and Nursing staff noticed patient to be unresponsive with 10-20 seconds of mild jerking movements. Patient able to regain consciousness and state that he has a history of seizures Blood pressure124/80, blood glucose 63. Patient transported by EMS to hospital.


VAERS ID: 1182293 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Fall, Headache, 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), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), 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: NA
Current Illness: none known
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Patient left pharmacy and passed out on the sidewalk. Unknown if vaccine or fall caused Nausea, Headache, Memory loss.


VAERS ID: 1182308 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Deafness, Dizziness
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: Patient reported feeling dizzy, nauseated, Loss of hearing and lightheaded ness Patient seen by medical team, refused medical transport, stated symptoms improved, signed AMA form


VAERS ID: 1182313 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Confusional state
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: BP: 127/84 HR: 82 PO2: 97%
CDC Split Type:

Write-up: Confusion reported


VAERS ID: 1182319 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Muscular weakness, Paraesthesia, Peripheral swelling, Rash erythematous, Throat irritation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: VACCINE WAS ADMINISTERED AT 9:33 AM. PATIENT WAITED 30 MINUTES AND LEFT AT 10:00AM. PATIENT RETURNED TO PHARMACY AT 10:45AM STARTING SHE STARTED HAVING A REACTION AROUND 10:30AM. PATIENT WAS TINGLY, BOTH ARMS WERE SWELLING AND HAD A RED RASH, AND SCRATCHY THROAT. PATIENT ALSO FELT WEAKNESS IN BOTH ARMS AND FATIGUE. BENEDRYL 50 MG WAS ADMINISTERED AT 10:45 AM BY MOUTH. PATIENT WAITED FOR 30 MINUTES DID NOT RESPOND TO BENEDRYL. PRIMARY DOCTOR WAS PHONED AND HE RECOMMENDED ADMINISTERING EPINEPHERINE. EPINEPHERINE WAS ADMINISTERED AT 11:15 AM IN RIGHT THIGH. PATIENT WAITED 5 MINUTES AND STABILIZED. PATIENT LEFT PHARMACY AT 11:20AM


VAERS ID: 1182328 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Incoherent, Pallor, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Approximately 5 minutes after vaccine patient felt lightheaded. Pharmacist immediately checked on patient who was beginning to become incoherent. He had a mild seizure and ems was called. Patient was sweating and pale. He remained onsite with EMS and later left with a family memeber.


VAERS ID: 1182336 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Patient reported feeling shaky and dizzy Patient seen by medical team and refused medical transport and signed AMA form Patient stated symptoms improved Patient driven home by family


VAERS ID: 1182338 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP: 151/81 HR: 89 POx:97%
CDC Split Type:

Write-up: Syncope for 15-30 sec. head trauma. Neg. concussion screen test.


VAERS ID: 1182501 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Flushing, Muscular weakness, Nausea, Swollen tongue, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Descovy, isentress, valtrex, isosorbide mononitrate, asa, loratadine, synthroid, protonix took all those med prior to getting vaccine. I took them at 8am / 9am
Current Illness: None I got the J & J vaccine and then went to ER
Preexisting Conditions: Hiv, peripheral neuropathy, gastritis, hypothyroidism, migraines, vertigo, variant angina, h/o hemturia
Allergies: Percocet, codeine, morphine, euflexxa, adhesives, Topamax, Zanaflex, spiders, augmentin, eliquis, cardiac, Cardizem, isosorbide mononitrate, eucrissa, tropical, solumedrol, depomedrol, and PEG
Diagnostic Lab Data: None just given decadrom IM, benadryl and famotudine in 0.9% sodium chloride at 11:39 am, 11:40 am, respectively and pepcid stopped at 11:54am
CDC Split Type:

Write-up: Body flush like when getting CT scan dye, leg weakness,, nausea,, swollen tongue, feeling like throat closed over difficulty breathing. Happened immediately after getting J & J covid vaccine.


VAERS ID: 1182504 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Influenza like illness, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Flu-like symptom(s): Serious body ache, increased body temperature, muscle soreness.


VAERS ID: 1182510 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Lip swelling
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:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported having mild lip swelling Patient seen by medical team and refused medical transport and signed AMA form Patient stated symptoms improved and will take benadryl at home


VAERS ID: 1182511 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Feeling hot, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, diltiazem
Current Illness: none
Preexisting Conditions: Chronic Tachycardia
Allergies: Flagyl, doxacycline
Diagnostic Lab Data: ECG, VS, Juice, crackers, oral tylenol
CDC Split Type:

Write-up: Lightheaded, slight nauseau, feeling of heat


VAERS ID: 1182521 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Rash, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 142/84 P 78 RR 24
CDC Split Type:

Write-up: hives, wheezing, hx of compromised lungs. Benadryl and EpiPen administered. Hives on left and right side of neck and anterior chest


VAERS ID: 1182540 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Lip swelling, Skin tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/96 P 77 POx 97%
CDC Split Type:

Write-up: Swelling of lips and confusion, feeling of lip and cheek tightness. EMS called


VAERS ID: 1182544 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: -Pt received J&J vaccine to her right arm at 2:16pm. Pt informed Observer that she felt dizzy at 2:20 pm in which I was informed immediately. I walked over to patient and she was sitting in observation area with her head in between her legs. She stated she felt dizzy with no other symptoms, no difficulty breathing or throat closure. Pt was then moved to the cot so that she can lay and elevate her legs. Pt stated that she has a tremendous fear of needles. This happens more often than not when she gets vaccines or blood drawn. I took pt''s first set of vitals that read BP: 130/60 HR: 73 O2: 100% RR: 20. I then stayed with pt for 10 minutes before repeating vitals. Repeat Vitals at 2:30pm were BP: 132/60 HR: 75 O


VAERS ID: 1182552 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Dizziness, Dyspnoea, Feeling abnormal, Feeling cold, Hyperhidrosis, Hypoacusis, Loss of consciousness, Mental impairment, Skin burning sensation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hearing impairment (narrow), 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: Acyclovir 400mg 2x daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After receiving the shot, I was required to sit down for 15 minutes. About 5 minutes in, I started to become dizzy, my vision started blacking out, my hearing was muffled, I became clammy, sweaty, and experienced mental disorientation. It became harder for me to breathe, but I never struggled to take a breath. I drank some water and waited for the symptoms to subside. I remained seated and these symptoms went away within 5 minutes. After feeling better for about 5 minutes, I felt cold and was shivering. The woman sitting next to me was completely fine after her shot. I''ve since felt a slight burning sensation on my skin in areas that I have scratched lightly. I''m also experiencing strange feelings throughout my body- specifically my head, leg, and hand. It feels like I can feel something in each area for a bit and then it subsides after several minutes.


VAERS ID: 1182559 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Hyperhidrosis, Immediate post-injection reaction, Nausea, Syncope, Tinnitus, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Immediate ringing and loss of hearing in ears, blurred/starry vision, excessive sweating, nausea, and faintness.


VAERS ID: 1182568 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Head injury, Unresponsive to stimuli, Vital signs measurement
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 122/78 POx 96% HR 72
CDC Split Type:

Write-up: Fell off chair, striking head on floor. Briefly unresponsive No breakfast eaten.


VAERS ID: 1182591 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 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 was immunized at 17 years old and 8 months.


VAERS ID: 1182592 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lip pruritus, Oedema, Vital signs measurement
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: BP 131/89 HR 77 POx: 96%
CDC Split Type:

Write-up: Lips itchy, edema, given Benadryl 25mg. symptoms resolved.


VAERS ID: 1182599 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0434A21A / 1 LA / IM

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

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

Write-up: POSSIBLE SYNCOPE-PT FELT DIZZY PULSE WAS 51, BP WAS 133/91. FRONT ASSOCIATE CALLED 911 AND AMBULANCE CAME AND REFUSED TO GO AND WAS ABLE TO GET UP AND WALK OUT


VAERS ID: 1182605 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Nausea, Peripheral swelling, Pruritus, Tachycardia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Quadrivalent Flu Vaccine
Other Medications: Androgel, Diclofenac, Jardiance, Lisinopril, Metformin, Mulitvitamin, Omega 3, Sertraline,
Current Illness: Hospitalized for cellulitis at the end of February
Preexisting Conditions: Diabetes/ OSA
Allergies: Flu Vaccine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 10 min after receiving vaccine patient became flushed, feels like arms are swollen and itching, nausea, and sweating. Patient went to ER and they noted tachycardia and diaphoresis


VAERS ID: 1182609 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: Administered Janssen COVID-19 vaccine to pt and had him sit in designated chairs for monitoring. A couple of minutes later he said he was feeling light-headed. We had him stay seated in the chair and I went and got the BP machine. I had the technician taking notes. Checked BP and it was 67/35 pulse 75. I advised him that we will have him lie down and elevate his feet to help increase his BP but he declined and stated that this usually happens with needles. I checked his BP again and it was 79/28 pulse 71. We gave him a bottle of water and very shortly after he expressed he was feeling much better. At no point did the patient have trouble breathing or was experiencing any symptoms of allergic reaction/anaphylaxis. I had patient stay seating for another 10 minutes and checked his BP one last time and it had come up to 110/77 pulse 79 and he expressed he was feeling back to normal.


VAERS ID: 1182615 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Eye movement disorder, Hyperhidrosis, Loss of consciousness, Muscular weakness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient at Vaccination table, just received dose of vaccine when patient''s arm went limp. Also developed generalized weakness. Mother stood in front of him and held his head with both hands. Patient then passed out with eyes rolling in back of head. Also had convulsions for a few seconds that mimicked seizure. Patient soon became alert. Vitals obtained with BP 92/52, HR 34, O2 96% on RA. Patient also diaphoretic to touch. EMS activated and arrived at 1:30pm. Placed in reclining wheelchair and taken to private area. Started to feel better after given cold water. Suggested ER due to having seizure first time. Declined ambulance but mother will take to ER in private car. Patient and mother left with no further incident.


VAERS ID: 1182639 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Violent chills, fever of 101, aches


VAERS ID: 1182658 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

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

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

Write-up: Patient received Janssen Covid 19 shot. Waited appropriate 15 minutes, had no reactions, and continued shopping. An hour and a half later, patient returned stating she felt dizzy. She sat at the pharmacy for 15 more minutes with a cold pack. She then felt better and went home.


VAERS ID: 1182666 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Blood pressure decreased, Dizziness, Nausea
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Severe nausea, dizzyness, fainted, severe blood pressure drop


VAERS ID: 1182691 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Loss of consciousness, Malaise, Musculoskeletal stiffness, Pallor
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), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Patient came in for vaccine. After vaccination, I had patient sit in a chair in case of any adverse reactions. About 5 minutes after vaccination, another patient came over and said that was not feeling well. When going out to patient I noticed he was very pale and sweating. The patient then proceeded to pass out. I was able to hold the patients head and the other customer was able to hold his shoulders to make sure he did not fall out of the chair. The patient then got very stiff and proceeded to push back in his chair, after about 10 seconds he relaxed. The patient was passed out for about 3 mins, during that time I was able to remove his mask and hold his head. After gaining consciousness, I was able to make sure he was ok. We were able to give him some water and he stated he felt better. I asked the patient to stay for another half hour to monitor. After giving the patient another bottle of water, and having him sit he was able to get up and leave.


VAERS ID: 1182699 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye movement disorder, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: NONE. Per patient he was on diet and had only 300 calories throughhout the day
Preexisting Conditions: None
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had an episode of fainting about 10 mins after vaccine administration. after regaining consciousness he had rolling eyes and seizure and 2nd episode of fainting. The fainting episodes were for few seconds (30-45 sec). Patients feet were elevated and paramedics were called. while waiting for the paramedics we had patient drink water and orange juice as he was on diet and had taken only 300 calories per patient. Used cold compress on his face and neck, patient was comprehending well afterwards. paramedics arrived and examined the patients vital and asked if he would like to go to the hospital even though patient seemed fine. Patient denied going to the hospital and paramedics left afterwards. patient waited for 30 minutes afterwards and then left. we called the patient later and he was doing fine.


VAERS ID: 1182707 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, weakness, and runny nose


VAERS ID: 1182716 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-03-31
Onset:2021-04-08
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyskinesia, Feeling hot, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (narrow), Anticholinergic syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Recieved 28 units of dysport on 04/07/2021 @ approximately 245pm.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid vaccine recieved 3/31/21. Dysport recieved 04/07/21. At approximately 430am, I awoke to full body tremors, fever, extremely hot face, inability to control body movements. Lasted approximately 2 hours.


VAERS ID: 1182727 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-04-08
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK RA / -

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

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

Write-up: rash


VAERS ID: 1182730 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Activated partial thromboplastin time shortened, Blood culture negative, Blood lactic acid normal, Chest X-ray normal, Chest pain, Chills, Differential white blood cell count normal, Dyspnoea, Electrocardiogram normal, Fibrin D dimer normal, Full blood count normal, Hyperventilation, International normalised ratio increased, Metabolic function test, N-terminal prohormone brain natriuretic peptide, Prothrombin time prolonged, Tremor, Troponin I, Urine analysis normal
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen 500 mg TID PRN pain; albuterol 90 mcg/inhalation 2 puffs QID PRN chlorhexidine topical 4% BID PRN folliculitis fluticasone-salmeterol 500 mcg-50 mcg inhalation 1 puff BID lisinopril 10 mg daily warfarin 5 mg daily warfarin 2 m
Current Illness: none
Preexisting Conditions: Factor V Leiden mutation asthma obstructive sleep apnea hypertension morbid obesity folliculitis
Allergies: soy products
Diagnostic Lab Data: 04/08/2021 at emergency room: INR 2.0, PT 21.3, PTT 31 Blood culture x 2 = negative Urinalysis normal lactic acid, comprehensive metabolic panel, CBC with differential, NT proBNP, troponin I ultra sensitive, D-dimer, - all normal chest x-ray unremarkable electrocardiogram 12-lead normal
CDC Split Type:

Write-up: 1:22 AM: chest pain, abdominal cramps, chills, difficulty breathing, hyperpnea, bilateral upper extremity trembling VS: pulse 112, respirations 22, temperature 37.0 Celsius, BP 156/103, O2 sat 99% on room air has history of deep vein thrombosis, pulmonary embolism 1:30 AM sent to emergency room via ambulance 4:00 AM report from emergency room: patient is stable and reported feeling better and breathing easier shortly after arriving to ER. Patient received 500cc NS bolus IV. Labs findings unremarkable. INR 2.0, PT 21.3, PTT 31. Last taken VS -BP 127/71, P109, R20, O2 93%RA. Patient will be discharging with Dx: reaction to COVID vaccine.


VAERS ID: 1182811 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Hypertension, Vital signs measurement
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was observed post vaccination complaining of dizziness & light headedness, pt brought to triage and attended by the doctor. Ekg was normal, pt sitting on gurney with pt''s husband at bedside, EMS was also at bedside, pt was initially hypertensive, the rest of the vitals were normal, pt was give orange and apple juice, tolerated, observed further, vitals improved, pt denies any complaints and discharged. Pt wheeled off unit by nurse.


VAERS ID: 1182816 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: after a couple of minutes of administration of vaccine , patient had difficulty breathing. , became unresponsive. was administered epipen 0.3mg autoinjector , a second dose was administered 5 minutes later. patient became conscious. paramedics took patient to ER


VAERS ID: 1182828 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Dizziness, Fatigue
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:
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up day after vaccination with chills, dizziness, exhaustion and a temperature of 99. As the day progressed, temperature went up to 101.8, then steadily declined into the evening.


VAERS ID: 1182833 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 - / SC

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Pharyngeal swelling, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin C, allegra
Current Illness: no
Preexisting Conditions: non
Allergies: Systemic allergic reaction 3 times to allergy shots, one adverse reaction to extreme selling to a filler
Diagnostic Lab Data: Checked out by ma, did workout at Urgent care by PA or doctor
CDC Split Type:

Write-up: About 15 minutes had urge to cough, tickling in throat, redness in throat and started to feel swelling. Had my own kit of epic pen, steroids, Pepcid and Benadryl. Injected myself because the MA at site injected herself and not me, so had another. Did pen, 2 Benadryl, 2 20mg prednisone, I Prevacid. Drove to urgent care and had them monitor me. All the about seemed to work to relieve the swelling and not gonna watch myself for 24 hours. I have environmental allergies and have reacted to 3 allergy shots with similar symptoms listed above. Had to stop doing them. Please look at people with severe allergies as a group to not require these shots.


VAERS ID: 1182838 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A RA / IM

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

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

Write-up: Patient felt light-headed, sweaty and nauseous. Gave him a cold compress to the face. Sat for 15-20 minutes and felt better after a while and left the store.


VAERS ID: 1182843 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 43A21A / 1 LA / IM

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

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

Write-up: light headed , disorientated and black out


VAERS ID: 1182856 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling abnormal, Injection site pain, Muscular weakness, Vital signs measurement
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)

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

Write-up: Patient received Janssen Covid-19 vaccination today at approximately 6:20pm. At 6:35, he said he had left arm weakness (arm he received vaccine in), fatigue, was dizzy, and felt "off". Patient did not lose consciousness and refused an ice pack. BP checked at 6:38pm (170/98, pulse 105). Patient stated his blood pressure usually runs high. I offered him an ice pack a second time, but he said there was no need and he felt better. BP checked again 6:52pm (152/101, pulse 99). I recommended that since his blood pressure is usually this high, he should follow up with his primary doctor regarding blood pressure as he may need some medication to assist in lowering it. He said ok. He left the pharmacy area at 7:02pm and said he was fine to leave, he did not want to remain any longer.


VAERS ID: 1182857 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180982 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Discomfort, Dizziness, Pain
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: bisoprolol-hctz 5-6.25mg, atorvastatin 10mg, caltrate 600+D, allegra
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA: 18 hours after getting the vaccine i began to feel dizzy, then got chills and body aches. There was no fever. Very uncomfortable though shivering under blankets in 72 degree weather. I expect the symptoms to lessen, have taken tylenol at 7:30pm and feel a little better now.


VAERS ID: 1182878 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / 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: so specifics given by patient
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: nickel
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient is 31 year old male who came in today to get his Janssen Covid-19 vaccine. He came with his wife and father-in-law. He verbalized ahead of time that he has a history of fainting due to his fear of needles. He does not have any allergic reaction to vaccine components. After reviewing his PQCF and possible side effects of the vaccine, patient verbally consented to get vaccinated. I administered the vaccine into the deltoid muscle of his right arm. I gave him an ice pack. Right after the vaccine was administered patient said he felt fine. He relocated from the immunization booth to a Post Vaccine waiting chair with his wife by his side. He fainted into his wifes''s arms for about 30 seconds. His father-in-law helped place him on his back on the floor and we raised his legs up on a chair. Patient came to immediately when placed on supine position and said he just needed to rest. We called Code White and assistant manager came to the scene. Patient was conscious and verbalized that he was feeling fine but should just rest. Patient continued to use ice pack and rested for about 30 minutes.


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