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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 87 out of 1,535

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VAERS ID: 1185153 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Jannssen COVID-19 Vaccine EUA


VAERS ID: 1185161 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, mild body aches. Fever temperature at 4/8/2021 7:00 pm: 99.8F. Fever temperature at 4/9/2021 7:30 am: 99.8F-100.3F


VAERS ID: 1185164 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

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

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

Write-up: The patent is 1 month younger than 18 years old


VAERS ID: 1185180 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Migraine, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PRESCRIPTIONS: Trazodone 50 mg, EYE DROPS: Timolol GFS 0.5%, Brimonidine Tartrate Ophthalmic Solution 0.15%, Latanoprost .005% OVER THE COUNTER: Vitamin D, Elderberry Gummies DIETARY SUPPLEMENTS: Arbonne protein shakes
Current Illness: NA
Preexisting Conditions: glaucoma
Allergies: penicillin, hydrocodone acetamin 5-325
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: All normal side effects started 6 hours after shot. Started with chills, fever, body aches, migraine headache, extremely tired, dizzy, nausea. Vomiting started 11 hours (5:00 am) after COVID-19 vaccine and lasted another 12 hours. Vomited at least 5 times. All side effects except a fever were gone after 24 hours from the onset of side effects. The fever was gone after 38 hours from the injection.


VAERS ID: 1185188 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-04-08
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Prominent ringing and muted sound in the left ear, sudden onset 6 days since vaccination.


VAERS ID: 1185231 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Hot flush, Migraine, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 20mg XR, Escitalopram 20mg
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, Migraine, Hot flashes and Chills, Muscle aches and pains


VAERS ID: 1185242 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dyspnoea, Flushing
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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: Asthma, diabetes
Allergies: Codeine, Penicillin, Serum, and vaccines allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Difficulty breathing, anxiety, flushed skin.


VAERS ID: 1185244 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysphonia, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Vestibular disorders (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: Armor Thyroid, HTN, and Cholesterol pills
Current Illness: no
Preexisting Conditions: Mild coronary arty disease, HTN, high cholesterol, Hashimoto''s Disease, smooth muscle auto immune disease, osteopenia
Allergies: Penicillin, opioids effects my breathing
Diagnostic Lab Data: no
CDC Split Type:

Write-up: 5 minutes after vaccine I felt a sharp pain in the middle of my head like a headache and thought it would go away and i got dizzier and dizzier for about 25 minutes, I started getting hoarse in my voice, and my heart rate went up.


VAERS ID: 1185247 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (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: Diabetes type 2, gout, HTN, hyperlipidemia, ESRD
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse reaction. Patient was given J&J at dialysis after receiving Moderna at the health department about one month ago.


VAERS ID: 1185261 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Discomfort, Dizziness, 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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tizanidine (muscle relaxer for back pain), Atorvastatin, Hydrochlorothiazide
Current Illness: Low back spasm
Preexisting Conditions: Hypertension, Hyperlipidemia, Allergic Rhinitis,
Allergies: Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient felt dizzy when sitting on the toilet, reports passing out and states that this was unwitnessed. She is uncertain how long she was out for, but notes it felt like a long time. Then someone came and helped her up from the toilet and took her back to the couch. She''s been feeling still a little lightheaded with "heavy muscles" and headaches.


VAERS ID: 1185263 (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: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Fall, Immediate post-injection reaction, Syncope, Tonic clonic movements
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient given COVID J&J vaccine and within a minute complained of being dizzy/faint. While seated, patient fainted, eyes rolled, arms and hands clonic/tonic activity which caused him to fall from chair. Doctor was able to hold on to upper back of patient as both fell to the floor. Patient hit head on carpet with not traumatic injury. 911 was called and by time of paramedic arrival the patient was alert and oriented. Patient was assited to wheelchair and taken to ED for evaluation.


VAERS ID: 1185275 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0911101-09651 / 1 LA / IM

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

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

Write-up: Soreness at injection site immediately after dose. About 9 hours after dose chills, headache, neck aches, and leg aches began. Fever was noticed around 1am pushing 101F. By morning, most were better.


VAERS ID: 1185286 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN-207A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dyspnoea, Sinus tachycardia
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Sumatriptan Citalopram Zyrtec
Current Illness: none
Preexisting Conditions: migraines
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dyspnea, Sinus Tachycardia, and Rigors. Accompanied by all other normal side effects. Symptoms began at 10pm, and ended around 5am. Treated with cold medicine and acetaminophen.


VAERS ID: 1185292 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Immediate post-injection reaction, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone, Desvenlafaxine, Pantoprazole
Current Illness: No illnesses.
Preexisting Conditions: Gastric Reflux, Irritable Bowel Syndrome
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately after receiving the vaccine, I experienced muscle pain which lasted for approximately two hours. At 7:00, three hours after receiving the vaccine, I developed a fever and slight nausea, as well as fatigue. I went to sleep at 9:00 and woke up several times during the night with a fever. At 3:00am, I woke up with severe nausea which lasted for an hour. At 6:30am, I woke up with a fever, headache, and muscle pain in my left arm and legs. I took two Advil at 6:40. At around 10:40 my symptoms were relieved.


VAERS ID: 1185297 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Feeling abnormal, Immediate post-injection reaction, Injection site mass, Injection site pain, Musculoskeletal stiffness, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Hypersensitivity (narrow), Arthritis (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: Hydrocholorothiazide, 12.5 mg. Metformin - 500 mg ER (2) 2x a day Glipizide Alprazolam 1 mg/ 1x/day Albuterol Inhaler Vitamin C Elderberry Immune Support Multi Vitamins
Current Illness: None other than seasonal allergies
Preexisting Conditions: Diabetes, asthma
Allergies: CT Scan Dye
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Immediate pain in the left arm below the injection site. Lump in the arm, below the injection side (3 inches below injection site). Pain into my neck and stiff neck immediately. Extremely elevated blood pressure (the next day) (173/103) My usual BP is around 118/75. Fuzzy head. Not dizzy, just fuzzy.


VAERS ID: 1185298 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 200 MG Bupropion Sr 150 MG Levothyroxine SOD 200 MCG Tolterodine Tartrate 2 MG D-Amphetamine Salt Combo 30 MG Nexium Acid Reducer 20 MG Montelukast 10 MG One a Day vitamin for women 50+ Advair Diskus 100/50 Ipratropium Bromide Na
Current Illness: None
Preexisting Conditions: Asthma (mild)
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine 6 hours after injection, my temperature was 101.4, my head was pounding and every inch of my body hurt and felt nauseated. Now that it has been just over 24 hours, temperature 99.2, I still have body aches (not as severe) and feel nauseated.


VAERS ID: 1185299 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Pain, Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (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: Vertigo attack
Preexisting Conditions: Vertigo, tinnitus
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 4 hours after receiving the vaccine, I developed a hissing sound in both ears. 26 hours later it is still prevalent. I?ve never had hissing before in my ears but have had some clicking occasionally. I also had a low grade fever, mild body aches and a headache, which lasted 24 hours.


VAERS ID: 1185307 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 is 17 years old and received a Janssen COVID vaccine, which is not currently approved by the FDA in this age group.


VAERS ID: 1185312 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: None reported
Current Illness:
Preexisting Conditions: None Reported
Allergies: Prednisone
Diagnostic Lab Data:
CDC Split Type:

Write-up: The feeling of anxiety and swelling of tongue


VAERS ID: 1185324 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Head injury, Loss of consciousness, Musculoskeletal discomfort
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (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), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Vital signs taken.
CDC Split Type:

Write-up: Client seen face down on floor. At first, client seemed like he could be convulsing so 911 was called immediately. 2 PHNs and one safety officer came to be with the client and assess. Client suddenly woke up after being on the ground for approximately 5-10 seconds. Client was awake and able to talk. Client?s legs were elevated on a chair. Per safety officer, client hit left forehead on ground. Dr. came over to assess the client. Vital signs taken. BP=152/71, HR=72, 99=O2. Client explained that he had yogurt and honey along with coffee that morning for breakfast. Client explained that he has feeling lightheaded at first when walking back to observation area, he sat down, and then he suddenly woke up on the ground. Client did not want offered ice pack for his forehead. Dr. gave the OK to cancel EMS after assessment of client. Client given juice, fruit strips, and water. Client moved carefully to chair with armrests and seen sitting with roommate, which he came to the clinic with. Rechecked client again around 1045. BP=127/79, HR=68, and O2=98%. Client said his head was feeling OK, but neck felt like it was tweaked but said a hot shower would likely help. Client said he did not need an ice pack. Dr. reassessed the client saying he was good to go. Before client left, he was given additional fruit strips and juice. Client walked out of clinic with roommate.


VAERS ID: 1185357 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A (have had a sulfa drug reaction in past)
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Johnson & Johnson COVID-19 Vaccine Chills Headache Nausea Fever 102


VAERS ID: 1185394 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Blood pressure increased, Diarrhoea, Dizziness postural, Headache, Impaired work ability, Nausea, Nervousness, Pain in extremity, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 75 MCG Hydrochlorothiazide 12.5 MG Telmisartan 80 MG
Current Illness: High Blood Pressure Congestion due to Pollen Allergies
Preexisting Conditions: Hypothyroidism Hypertension
Allergies: None
Diagnostic Lab Data: No laboratory test performed.
CDC Split Type:

Write-up: 4/6/21 (2pm) Arm slightly sore after shot. No symptoms at all for 32 hrs. 4/8/21 (3:12am) woke up to use restroom and I felt as though I was spinning. Dizzily staggered to the restroom and back. Laid down and my body felt like it was slowly spinning. At (7:45am) called my employer to work from home. Checked my blood pressure (8am) and it was elevated at 142/96. Throughout the day everytime I stood up I felt like I was dizzy as though I was walking on a moving boat. With the dizziness I felt nauseated. I had diarrhea several times during the day especially within an hour of eating anything. If I bent down I was dizzy. Looking to the left or right dizzy. My dizziness would subside when I was sitting stationary and looking forward. Blood pressure at (4:20pm) 142/95. At (9:15pm) I started to get a headache so I took one Excederin Migraine and it went away. Blood pressure at (10:09pm) 144/91. 4/9/21 (6:15am) Dizziness 50% better, no spinning but feel unbalanced. Feel weak and shaky even after eating. No diarrhea so far and current time is now 1:11pm. Blood pressure at (1:11pm) 130/91. My blood pressure before taking Jansen was 118/80 on 3/27/21.


VAERS ID: 1185397 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol 10mg/weekly IM injection Avodart .5mg/day
Current Illness:
Preexisting Conditions: Transgender woman, post op
Allergies: Wheat/gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe body aches began at 11pm on 4/8. Then, a high fever - the worst fever I?ve ever had in my life. That lasted until 8am on 4/9. Now, I have chills and nausea - still ongoing.


VAERS ID: 1185418 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 020 042H21H / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Chills, Hyperhidrosis, Loss of consciousness, Nausea, Pain
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), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Felt a bit congested the day of (likely seasonal allergies)
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2:00 am woke up with teeth chattering, cold chills, body aches continued to wake up through the night almost hourly in extreme body pain 6:00 am woke up in severe pain, stomach cramping, lower back pain, nauseous, attempted to get myself water and had to sit down in the kitchen in fear of passing out, barely made it back to bedroom before almost passing out again and immediately broke out in a profuse sweat. Body pain and aches continue for rest of day and into the next.


VAERS ID: 1185434 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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, fatigue, nausea, headaches, muscle soreness.


VAERS ID: 1185445 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Mouth swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Second Hep B vaccine. She had an allergic reaction similar.
Other Medications: unknown
Current Illness: N/A
Preexisting Conditions: unknown
Allergies: said she had reactio0n to the Hep B vaccination only the second dose. Said she had reaction to her 5th immune shots, Allergy to Olives.
Diagnostic Lab Data:
CDC Split Type:

Write-up: After 20 minutes the patient began to feel swelling in her mouth. EMS checked all vitals and they were all good. They looked inside her mouth and saw some swelling. At 2:05 the EMS gave a shot of Benadryl to patient. Patient was seen fine and working after.


VAERS ID: 1185447 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Parkinson-like events (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: Multi-vitamin, Calcium, Omega-3
Current Illness: none
Preexisting Conditions: none
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nerve pain in the upper left arm (the OPPOSITE arm from the injection). Severe pain limiting use of arm. Pain first noticed upon waking up the morning after the vaccine. Seems to be consistent with the symptoms of Brachial Neuritis.


VAERS ID: 1185466 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Gaze palsy, Headache, Hyperhidrosis, Insomnia, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I started experiencing side effects about 6 hours after receiving the vaccine. I experienced chills, sweating, 99.5 fever, headache, head pounding, dizziness, nausea, tiredness, sore body, sore left arm, and had trouble sleeping. I took two Motrin pills and felt a little better and was able to sleep. In the morning, I woke up tired, sweating, had a sore left arm and sore body so I took two more Motrin pills and am feeling mostly better. Fever, headache, head pounding, dizziness, and nausea are gone.


VAERS ID: 1185471 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Chills, Dizziness, Fatigue, Feeling abnormal, Flushing, Headache, Hot flush, Nausea, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (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: Lo LoEstrol (birth control)
Current Illness:
Preexisting Conditions: Vasovagal syncope Vestibular neuronitis
Allergies: Possibly Metronidazole
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, hot flashes, brief knee pain twinges, face flushed, headache. These effects lasted for two hours, then I had anxiety and trouble sleeping for rest of night. The headache carried on into the morning and became severe. Upon taking Advil, the pain drastically decreased. I had a mild headache, along with fatigue, a little queasy after eating and an unpleasant spacey/dizzy/heady feeling for the rest of the day. By morning of the 9th, all effects ceased.


VAERS ID: 1185482 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Headache, Hyperhidrosis, Pain
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Coreg, Methotrexate, Nifidipene, Hydrochlorothiazide, CBD tincture 1000 mg
Current Illness: Scleroderma and RA
Preexisting Conditions: Scleroderma and RA
Allergies: Gluten and dairy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extended burning sensation during injection, body aches, sweats and headache all night and today


VAERS ID: 1185499 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Duloxetine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 18 hours of fever 101.5, muscle aches, headache, nausea, chills. Next 12 milder symptoms of achy. Note that patient tested positive for covid n 11/10/2020


VAERS ID: 1185505 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Hyperhidrosis, Loss of consciousness, Pain, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 5 minutes after the patient received his vaccination, he rested his head on the wall behind him in the chair he was being observed in and passed out and turned white. His wife began slapping his face and screaming his name and the observer called for me. I arrived within seconds and assisted his wife in moving him from the floor to the chair. Within seconds of getting his head to the ground safely, he came back to and was very sweaty, red in the face. He stayed on the ground laying down, and then sitting for approximately 25 minutes. During that time, he told us that he had previously passed out during 3 procedures done at doctors offices. We got him an ice pack and a orange pop as he was complaining of being hot and having only eaten a granola bar all day. He was able to get up to a chair and sat there for an additional 5 minutes, before he was able to walk out on his own accord. I have spoken with the patient twice since, once last evening and once today and he reports he feels great now besides the expected body aches from the vaccination.


VAERS ID: 1185512 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not reported
Current Illness: not reported
Preexisting Conditions: not reported
Allergies: not reported
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: back pain. could be do to regular work because patient went back to work right away and performed regular lifting duties.


VAERS ID: 1185518 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bone pain, Chills, Headache, Impaired work ability, Influenza like illness
SMQs:, Osteonecrosis (broad)

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

Write-up: COVID-19 Vaccine EUA got J&J vaccine shot @ 2:00pm on Wed, April,7th woke up approx. 2:00am in trembling chills , woke up again @ 7:00a with fever , nagiated and feeling a flu like symtoms, headache , sore bones , been out of work two days now and starting to feel a little better but not anywhere near normal yet and don''t have any alergies or alergic to anything.


VAERS ID: 1185520 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (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: Muscle twitching of lower lips every 5-7mins


VAERS ID: 1185543 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BREO 200-25 AEPB; CYANO 1000MCG SOLN; ARMOUR T 60 MG TAB
Current Illness: HX OF CVA AND ASTHMA
Preexisting Conditions: HX OF CVA AND ASTHMA
Allergies: NO KNOWN DRUG ALLERGY
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PT RECEIVED VACCINE ON 04/05/2021 IN THE EVENING. THEN, IN THE EVENING ON 04/08/2021, PT EXPERIENCED "SPONTANEOUS ITCHING AND HIVES" WHILE AT HOME. PT THEN TOOK OTC BENADRYL AND CORTISONE CREAM WHICH "HELPED." HOWEVER, IN THE MORNING ON 04/09/2021, PT WOKE WITH THE SAME SPONTANEOUS ITCHING AND HIVES AGAIN. THE PT NEVER EXPERIENCED ANY TROUBLE BREATHING AT ANY POINT. PT AND HER HUSBAND DO NOT FEEL IT IS SOMETHING THEY NEED TO BE SEEN AT A HOSPITAL FOR, BUT WANTED TO REPORT THIS REACTION AS THEY DO NOT BELIEVE IT IS CAUSED BY ANYTHING, OTHER THAN THE VACCINE.


VAERS ID: 1185557 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A27A / 1 RA / IM

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

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

Write-up: About 5 pm I started to feel very run down, I quickly started feeling worse and by 7 pm had a 101.5 fever and aches all over my body


VAERS ID: 1185883 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Injection site pain, Injection site swelling, Menstrual disorder, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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:
Current Illness: UTI
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, headache, sweating, chills, body aches, injection site soreness and slight swelling, started mentrual cycle early for one day, tired


VAERS ID: 1185884 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dyspnoea, Dysstasia, Fatigue, Hyperhidrosis, Injection site pain, Injection site swelling, Migraine, Nausea, Neck pain, Pain, Pyrexia, Swelling face, Toothache, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Linzess Lexapro Magnesium citrate Women?s vitamins Synthroid
Current Illness: History of GI issues, thyroid issues, major colon resection
Preexisting Conditions: IBD, hypothyroid, possible autoimmune arthritis
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe migraine that caused facial swelling / tooth pain, high fever, chills, nausea / vomiting, sensitivity to light, severe body aches and shooting neck and arm pain in injection site, shortness of breath, inability to hold down fluids or food. On second day, still severe fatigue / having trouble standing and sweats / chills / migraine / nausea. Upper jaw Tooth pain is gone on right side. Symptoms started on right side of body and then spread out. Injection site swelling and pain. Nearly went to the ER, will follow up with my doctor when I can get to the doctor, managing with tons of Advil.


VAERS ID: 1185913 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 UN / IM

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

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

Write-up: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: The patient fainted within 5 minutes of getting the vaccination. When she regained consciousness, she stated that she tends to pass out after contact with needles and it has happened several times previously.


VAERS ID: 1185942 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Pallor, Pulse abnormal
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: On ALS exam pt alert, oriented. Pt states he has a history of passing out after getting a needle or having blood taken. Pt rcv''d J&J vaccine, and once in the monitoring area, he became lightheaded. Pt pale w/ thready radial pulse palpated on initial ALS contact. Pt placed seatback in reclined position and elevated feet on dashboard. Radial pulse strong on palpation. Pt symptoms subsided, color improved. V/S as shown. Pt returned seatback to upright position, and remained without complaint. Pt states he feels much better now. Pt exits vehicle and enters front passenger seat as his companion was going to drive home.


VAERS ID: 1185944 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Chills, Dizziness, Facial pain, Feeling abnormal, Gait disturbance, Headache, Malaise, Muscular weakness, Myalgia, Pyrexia, Vertigo, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Osteoarthritis
Allergies: Wheat, dairy
Diagnostic Lab Data: None, too sick to go anywhere
CDC Split Type:

Write-up: Severe muscle pain throughout body, legs and arms weak to the point of not being able to walk or get to the bathroom, chest pain, severe head/face pain, dizziness/vertigo, chills, fever, vomiting. Was so bad that I thought about calling 911. 15 hours later - muscle pain remains, head exploding pain, dizzy.


VAERS ID: 1185947 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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

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

Write-up: Headache, nausea, weakness, and fainted the next evening


VAERS ID: 1185968 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montekulast 10mg, gabapentin 100mg, omeprazole dr 40mg, levocetirizine dhcl 5 mg, vitamin d3 2000mcg
Current Illness: None
Preexisting Conditions: None
Allergies: Ultram
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe body aches, fever, nausea,


VAERS ID: 1185971 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dysgeusia, Pain in extremity
SMQs:, Taste and smell disorders (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Metal taste in mouth with soda, water, coffee. 26 hours after vaccine and still have the metal taste. It started right away. I also had a sore shoulder that has turned into a sore arm.


VAERS ID: 1185978 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram normal
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: Venlafaxine
Current Illness:
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: AOS Found a 24 yo male pt complaining of being dizzy and lightheaded. Pt had just received the J&J Covid vaccine. Pt denies any previous syncopal episode post vaccine in the past. Laid pt back in his seat. 12 lead obtained unremarkable. Pt rested for awhile then stated he was beginning to feel better. Repeat vitals obtained.


VAERS ID: 1185979 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, 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 specified
Current Illness: None
Preexisting Conditions: Hypertension, Gout, Coronary Artery Disease
Allergies: kna
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports severe headache, nausea and vomiting starting about 6 hours after vaccine. Sometime during the night a fever of 104 which went away with Advil. Nausea/Vomiting/Headache still occurring 14 hours later.


VAERS ID: 1185983 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Blood creatinine normal, Endotracheal intubation, Platelet count normal, SARS-CoV-2 test negative, White blood cell count increased
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bupropion Citalopram Diclofenac hydroxyzine Trazodone
Current Illness: B cell lymphoproliferative disorder, marginal zone lymphoma (not treated, on surveillance)
Preexisting Conditions: ? Allergic rhinitis ? Depression with anxiety ? Menorrhagia 2004 ? Tobacco dependence ? Uveitis
Allergies: Apple Gabapentin
Diagnostic Lab Data: 4/8/21: WBC 16 PLT 189 Cr 0.7 Sars-COV2 PCR swab negative
CDC Split Type:

Write-up: Anaphylaxis leading to intubation and hospitalization


VAERS ID: 1185984 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: history not avail
Current Illness: n/a
Preexisting Conditions: N/A
Allergies: marked no allergies to medications on vaccine form
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient came into pharmacy obtaining Rx''s for medrol dose pack and benadryl. She mentioned yesterday (4/08) around the afternoon her arms started to itch so she used hydrocortisone cream. By 4:30 in the morning (4/09) she woke up with her lips swelling.


VAERS ID: 1185990 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: fever, chills, muscle and joint aches, nausea and vomiting


VAERS ID: 1185991 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Pt received Moderna prime on 4/2/2021 at a Medical Center. Pt denied history of vaccine in 2 weeks and denied ever having a COVID vaccine prior to receiving his scheduled Janssen vaccine on 4/7/2021. Contraindications denied. Pt was administered the Janssen vaccine without any complications noted. Upon inputting vaccines into KYIR we discovered the history. Vaccine was confirmed on 4/9/21.


VAERS ID: 1186012 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Fatigue, Headache, Hypertension, Panic attack
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: PT IS A 49 YO/F REPORTING THAT SHE SUDDENLY FEELS TIRED WITH A HEADACHE. PT REPORTS THESE SYMPTOMS STARTED SOON AFTER HER SHOT. PT DOES NOT APPEAR TO BE IN ANY IMMEDIATE DISTRESS, WOB APPEARS NON-LABORED, SKIN IS WARM/DRY/COLOR APPROPRIATE. SHE IS AAOx4, SPEAKING AND ANSWERING QUESTIONS APPROPRIATELY. PT VITALS ARE OBTAINED AND SHE PRESENTS AS HYPERTENSIVE. PT ADVISES THAT SHE HAS BEEN DIAGNOSED WITH ANXIETY AND SHE BELIEVES SHE IS HAVING A MILD PANIC ATTACK. PT IS REASSESSED AND HER BP DECREASES. SHE STATES THAT HER HUSBAND IS COMING TO PICK HER UP FROM THE OBSERVATION AREA. DUE TO PT COMPLAINT OF HEADACHE AND ELEVATED BP, SHE IS ADVISED BY EMS CREW THAT SHE CAN NOT MEDICALLY CLEARED WITHOUT A PHYSICIAN EXAM. SHE IS ADVISED OF REFUSAL PROCEDURE AND POSSIBLE RISKS DUE TO HYPERTENSION. SHE REMAINS AAOx4 AND ADVISES THAT SHE UNDERSTANDS. PT SIGNS A REFUSAL AND HER HUSBAND IS ON SCENE TO PICK HER UP.


VAERS ID: 1186021 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache, Hypotension, Nausea, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Hypokalaemia (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: Celexa busiprone
Current Illness:
Preexisting Conditions: Mthfr genetic deficiency
Allergies: 0
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, dizziness, nausea, headache, low blood pressure, fatigue, body aches and chills


VAERS ID: 1186040 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood pressure increased, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypoglycaemia (broad)

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

Write-up: Increased anxiety, headache, blood pressure of 220/150.


VAERS ID: 1186055 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: full body allergic reaction, hives, swelling of throat


VAERS ID: 1186060 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone 100mg daily
Current Illness: None known
Preexisting Conditions: Autoimmune thyroiditis 12/22/2019; Vasovagal near syncope 04/23/2018; Concussion with no loss of consciousness 04/23/2018; Heterozygous MTHFR mutation C677T (CMS-HCC) 12/01/2016; Encounter for IUD insertion 10/12/2014; Paragard placed 10/4/19
Allergies: None known
Diagnostic Lab Data: EKG was obtained and found normal sinus rhythm without any acute changes.
CDC Split Type:

Write-up: Received vaccine and ambulated over to the observation area where she started feeling dizziness and nausea and then felt faint prior to fainting. Treated with ondansetron and IV fluids. Was discharged once symptom free and able to tolerate fluids without vomitting.


VAERS ID: 1186071 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia oral, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 5 minutes after shot my nose, upper lip and tongue went completely numb. within 15 minutes after that i got a horrible headache. It then progressed through the night with horrible body aches and a fever that is ranging between 100 & 101. I still have all of these symptoms and I feel horrible.


VAERS ID: 1186073 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Cough, Dizziness, Dysphagia, Dyspnoea, Electrocardiogram, Paraesthesia oral, Pharyngeal paraesthesia
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bioactive woman''s one daily multivitamin high potency (once a day)
Current Illness: Ear infection (was on Bactrim x 10 days, finished 3/26)
Preexisting Conditions: TIA x 2 (last one 2012), obesity, OSA, endometriosis, chronic interstitial cystitis, SLE, fibromyalgia
Allergies: Ibuprofen, aspirin, Alka-Seltzer, butorphanol, latex, meperidine, oxycodone-acetaminophen - causes anaphylaxis (sometimes face swelling, itching)
Diagnostic Lab Data: 4/8 - chest x-ray, 12 lead ECG
CDC Split Type:

Write-up: 12:30 - Received J&J vaccine 13:00 - Started to experience lip/gum tingling and chest tightness. Given Benadryl 50 mg PO x 1 in vaccine clinic. Symptoms progressed to throat tingling, coughing, difficulty swallowing, lightheadedness, some SOB. 13:15 - Transported to ED. Received IM Epi x 1; improved within a few minutes. Also received methylprednisolone, famotidine, IVF. 19:00 - Monitored in ED. Discharged home with Epi pen, prednisone, famotidine, Benadryl.


VAERS ID: 1186077 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Pyrexia, Respiratory tract congestion, 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: Niacin
Current Illness:
Preexisting Conditions: Metabolic syndrome, lipedema
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Client woke up at 1am the night of the vaccination with Chills, Fever, chronic vomiting. This continued for the next 36 hrs. Took Phenergan on hand to stop vomiting at 5pm second day. Continues now with mild headache and chest congestion.


VAERS ID: 1186080 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Mobility decreased, Pain
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (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: Avonex: 30mcg.-1 time a week took Sunday, the 4th. Day of Shot: Anastrozole- 1mg-1 pill daily Baclofen- 10 mg pill -1 tab in the morning and 1/2 @ night Low dose aspirin - 1 pill three times a week- took 1 that day Betimol-0.5 Sol
Current Illness: No
Preexisting Conditions: MS, Glaucoma, Macular Degeneration, 2x Breast Cancer Survivor still taking Anastrozole.
Allergies: Latex, Some adhesives in bandaids, polyethylene glycol, MS drug Mazent.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: after Midnight on the night of the 7th, it started with body aches. During the night I needed to go to the bathroom and could not get out of bed, needed assistance. On the morning of the 8th, I experienced chills and headache. Took Advil that morning and 4 hours after. Did start to feel better. Experienced Dizziness at times. Today, the 9th just chills throughout the day.


VAERS ID: 1186084 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)

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

Write-up: Excruciating upper back, top of shoulder,


VAERS ID: 1186092 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hypotension, Muscle rigidity, Muscle spasms, 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), Dystonia (broad), Parkinson-like events (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: EMS dispatched to the Vaccine Clinic for the syncopal. Found male supine in vehicle ico event paramedic. Stated male received a Johnson and Johnson vaccine. Stated he drove his car to the medical monitoring location. Stated he had a syncopal episode with muscle rigidity. IV established. Fluids administered. Vitals noted to be hypotensive. Patient-stretcher-ambulance. Patient stated he felt dizzy. Muscle rigidity present. Patient stated he feels his whole body cramping. Stated he remember events that occurred. Denies chest pain. Denies SOB. Denies ABD pain. Denies N/V. Stated he felt healthy prior to the vaccine. No incident during transport. Muscle rigidity resolved PTA at the ER. Patient received 900cc NS. Transfer of care to ER nurse w/ report.


VAERS ID: 1186127 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Ear pain, Headache, Heavy menstrual bleeding, Hypomenorrhoea, Menstrual disorder, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Fertility disorders (broad), Arthritis (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: Flu shots, very young age, gave me the flu so I no longer get flu shots.
Other Medications: Benadryl, flonase, advil, melatonin
Current Illness:
Preexisting Conditions:
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6-7 pm began a fever that lasted until the next morning. Did have a few moments of severe chills. Minimal nausea and dizziness. Sore joints, and entire skull hurt. Inner ears also hurt. Slept or 12 hours Headache was also present most of the day before the fever set in. My period started the day before and usually I have heavy days first. I had a light day after my injection and today it''s extremely heavy. So it messed with the flow.


VAERS ID: 1186128 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Flushing, Hyperhidrosis, Hypotension, Skin warm, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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 is found with secondary provider reporting the patient had an episode of syncope and hypotension. Patient reports that she is hot, diaphoreticand dizzy after receiving J&J Vaccine. A 12 lead ECG is completed as noted in chart. Patient''s vitals are taken as noted in chart. Patient reports that she is beginning to feel better, patient continues to be monitored by EMS. Patient is found A&O x4, flushed warm and diaphoretic. Patient has no noted neurological deficits, pupils are PERRL. No trauma is noted to patient''s face. Airway is patent, respirations are as noted. No JVD is noted, trachea is midline. Patient has equal chest rise/fall, lung sounds are equal bi-laterally. Patient denies chest pain, shortness of breath. Abdomen is soft/non tender. Patient denies abdominal pain, no GI/GU Symptoms are noted. Patient has no deficits noted to extremities, pulses are strong. Patient denies covid 19 concerns, other injuries or illness. 12 lead ECG is taken showing sinus rhythm as noted in chart


VAERS ID: 1186130 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-02
Onset:2021-04-08
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cough, Headache, Injection site erythema, Injection site swelling, Lethargy, Pain
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto Ambien Lorazapam Zoloft Multi-Vitamin Vitamin D-3
Current Illness: None
Preexisting Conditions: Anti-Phospholipid Anti-body Syndrome Hashimotos thyroditis Insomnia Mild asthma
Allergies: She?ll fish Penicillin Levaquin Keflex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swelling, redness and pain at injection site with 24 hours Lethargy, headaches, body aches, cough in last 2 days 4/8/2021


VAERS ID: 1186131 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling hot, Headache, Hypogeusia, Immediate post-injection reaction, Lymphadenopathy, Malaise, Nausea, Oropharyngeal pain, Pain, Pain in extremity, Sinus congestion, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot several years ago
Other Medications: dhea progesterone, testosterone cream, microgestin, levothyroxine, vitamin D, nexium, zyrtec
Current Illness:
Preexisting Conditions: Hypothyroid, hormone imbalance from premature ovarian failure, allergies
Allergies: Wheat, gluten, dairy, casein, curds, whey, chicken egg whites and yolks, cane sugar, mushrooms, sesame, yeast, molds, penicillins, lidocaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right away I started to feel very hot. I waited the time (15 minutes) they recomemnded to stay at pharmacy. I drove home and started to feel nausea, a light headache, and mildly dizzy. I started to get short of breath about 45 to 50 minutes after the injection. I climbed a flight of stairs and was completely winded I was having trouble catching my breath. My lymph nodes in my neck swelled up a lot and I was developing a sore throat and small bumps on roof of mouth. I called the nurses line and was directed to take a 50 mcg dose of benadryl and that if the shortness got worse to call 911 and use my epi pen. After about 2.5 hours the breathing seemed to primarily resolve itself and resume more normally. I woke up this morning with a very sore arm, body aches, a mild headache, congested sinuses, and with a sore throat. I do feel like I am not tasting as well as normal, it could be the congestion. I do not feel great but only seem mildly winded and short of breath walking across the house.


VAERS ID: 1186137 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fatigue, Feeling abnormal, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: Septra
Diagnostic Lab Data:
CDC Split Type:

Write-up: Have severe body aches, fever, fatigue, no energy. About 17 hours till I was able to get out of bed. I had COVID 19 in December and had identical symptoms.


VAERS ID: 1186145 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dizziness, Dizziness postural, Joint lock, Nausea, Nervousness, Pallor, Skin discolouration, Skin warm, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypoglycemia and occasional tachycardia
Allergies: None
Diagnostic Lab Data: Pt. reported to me that the ER gave him fluids and monitored him. He said they believed it was a severe vasovagal response. He has not yet followed up with a new doctor.
CDC Split Type:

Write-up: Pt. received the vaccine at approximately 2:44pm. Before I could hand him his card, his hands began trembling and he looked pale. I asked how he was feeling. He reported feeling shaky, dizzy, and very hot. I asked him if he was having any difficulty breathing, had tightness in his throat/airways, or even felt a tingle. He said no. Noting the time, I asked if he had eaten lunch. I asked if he has ever felt this way before. He said he had when he gets a "hypoglycemic attack." While not diabetic nor on any medications, he said he will occasionally get very low blood sugar. He said he had not eaten since early that morning. Another employee brought some juice I requested. I again asked him about symptoms related to anaphylaxis, to which was not an indication of an anaphylactic reaction. I gave him the juice to sip. I asked him again about symptoms. Because he was still dizzy, I took his blood pressure/heart rate. His BP was 160/119 and heart rate 96bpm. His color became more gray over the next several minutes. He was still too dizzy to stand, felt hot, shaky, and now nauseous. He handed over the juice and was given a receptacle if he vomited. We suspected a vasovagal response, but was still symptomatic after 10 minutes. Meanwhile, the other pharmacist tried to call his doctor''s office. We learned his doctor had moved away and he had not yet come in nor selected a new provider. We asked him if he felt he needed to be seen by a doctor. He said he did and agreed to us calling an ambulance. The ambulance arrived around 3:10. The EMTs took his BP. It had come down, but he could not stand up without his knees buckling. The EMTs got him on the stretcher and took him to the hospital.


VAERS ID: 1186157 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia oral, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (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: Asthma and other respiratory issues as a child.
Allergies: Motrin and spider bites
Diagnostic Lab Data:
CDC Split Type:

Write-up: Later at night on the same day as my vaccine, the roof of my mouth began to feel almost numb. There is no pain or swelling that I am aware of, but there is a sensation that has not gone away since that time.


VAERS ID: 1186158 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Diarrhoea, Insomnia, Joint swelling, Neuralgia, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, CBD cannabis tablet, omeprazole
Current Illness: None
Preexisting Conditions: Psoriatic Arthritis, IBS
Allergies: Doxycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: 102.2 degree fever. Tremors and shaking for hours and hours. Insomnia. Diarrhea. Nerve pain. Joint swelling. Loss of taste


VAERS ID: 1186172 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Pruritus, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra, Diabetic medications, Effexor, Requip
Current Illness: no
Preexisting Conditions: Diabetes, asthma and previous brain surgery.
Allergies: Avacados, pet dander and hazel nut.
Diagnostic Lab Data:
CDC Split Type:

Write-up: about 2 hours after the vaccine the patient complained of a burning feeling, itchy and tattoo became discolored. Patient has had the tattoo for 2 years.


VAERS ID: 1186175 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure measurement, Dizziness, Dyspnoea, Hyperhidrosis, Nausea, Skin discolouration, Skin warm, Vital signs measurement, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: U/A found EMS with 56 yo F seated in stationary vehicle, CAO x 4, c/o N/V and dizziness approx 10 mins after receiving her Covid vaccine (Johnson & Johnson). Paramedic advised that pt had initial BP of 90 mmHG systolic, 12 lead showed sinus rhythm w/o ectopy, and that he attempted ODT zofran w/o success due to pt''s vomiting, all prior to EMS arrival. Pt. denied CP, abd pain, diarrhea, fever, cough, HA, syncope, neck or back pain. Pt. stated she felt SOB immediately after vomiting. All assessments/interventions as noted in rest of ePCR. GCS= 15, skin pink, warm, diaphoretic. No obvious signs of trauma. Pt. assisted from vehicle to stretcher, secured w/ straps. VS taken, WNL. Abd. soft, non-tender to palpation. Cardiac monitor showed sinus rhythm, rate of 60 bpm. Pt. actively vomited x 3 while IV access attempted and established. Pt. given 4 mg zofran IV w/ improvement in N/V. Pt requested transport for further evaluation. During transport, pt''s VS remained WNL, and pt stated she was feeling better, that dizziness and nausea had stopped. Noted occasional unifocal PVC on 4 lead as well as increase of HR to 124 bpm for approx. 3 seconds during transport, then returning to baseline of sinus rhythm or sinus brady. Pt. stated she normally had a low HR and BP, and had felt palpitations in the past, but no episodes of palpitations today, including during transport. Pt. transported COLD traffic to where pt care, 12 lead, and report were transferred to RN in triage w/o incident.


VAERS ID: 1186205 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Hypotension, Loss of consciousness, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Effexor
Current Illness:
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was CAO x 4 upon EMS arrival. EMS 3 stated pt experienced a syncopal episode after getting her COVID vaccine. Pt had a brief LOC and was initially hypotensive. IV was initiated by EMS 3 and NS was started. VS were WNL upon EMS arrival. Pt skin was still pale and clammy during assessment. Pt stated this has happened in the past with shots and blood draws, however, she has never fully lost consciousness. Pt was still c/o dizziness. Pt requested transport to REX ER. Pt was on the cardiac monitor upon EMS 14 arrival and a sinus rhythm was noted. 12 lead revealed a sinus rhythm with no STEMI criteria met. Pt was able to stand and pivot onto the stretcher without incident. Pt secured via straps and loaded into the unit. Once in the unit, VS reassessed. NS was reduced to a KVO rate due to improvement in BP. Pt had received approx 200mL of NS at the time. Pt denied any chest pain, SOB, N/V, or abd pain. Pt only complaint was dizziness. Pt was initially very anxious and was coached through breathing techniques which improved her anxiety. EMS left en route to REX ER. Pt was monitored during transport with improvement in her condition. Pt skin color and condition improved and her VS remained WNL. Pt denied any complaints during transport other than dizziness which she reported was improving. EMS arrived at REX ER. Pt was taken into the ER triage area and was able to stand and pivot onto a wheel chair. NS DC''d, pt received approx 300mL total. Report given to the triage RN and care transferred to same.


VAERS ID: 1186225 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Dizziness, Feeling of body temperature change, Headache, Injection site pain, Neck pain, Pain
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After the HPV vaccine, I experienced injection site soreness and fatigue. Did not experience the chills or complete body aches.
Other Medications: Metformin and Adderall
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the vaccine on 4/8/2021 around 8:35am. I felt fine all day, only soreness at injection site. Later that day (around 6:00pm) I started feeling lightheaded, chills and a headache. My hands, feet, nose and hands were freezing but other areas of my body were warm. I also felt body aches- my lower back started with the aches and it spread up to my upper neck. Around 9:00pm I started feeling very hot and this hot/cold changes continued throughout the night. This morning of 4/9/2021 I have less of a headache however, my body is still very sore and I continue to experience the hot/cold changes.


VAERS ID: 1186232 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Unknown  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products, 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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine administration error - Patient was administered the Janssen vaccine inadvertently when the intended vaccine (Pfizer/BioNTech) was meant to be administered due to their age (17 Years old). This occurred at a mass vaccination clinic where both brands of vaccine were being administered; the patient had gotten into the incorrect line and ended up being getting immunized at a Janssen vaccination station. No harm noted to the patient and there were no issues during the observation period.


VAERS ID: 1186242 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Cough, Flushing, Oropharyngeal discomfort, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient is GCS 15, A&Ox4, with skin that is flushed, warm, and dry and a strong radial pulse. Patient is coughing. Patient states she received her vaccine about 30 minutes ago. She states 20 minutes after the vaccine was administered she began to feel itchy and as if something was stuck in her throat. Patient denies any allergies or respiratory history. The Vaccine Clinic standby units have already administered 50mg Benadryl PO prior to arrival. Lung sounds are clear in all fields. No stridor noted to auscultation. No redness or angioedema noted to patient''s airway. Patient''s skin is flushed on the chest. No urticaria noted. Patient denies and GI symptoms. An 18G IV is established in the RAC. 125mg Solumedrol administered IV. Patient requests transport to Rex ER. Transport is initiated non emergent to Rex ED. Enroute 0.3mg IM epi is administered. Patient reports her itchiness is gone after Epi administration but is still coughing and states she still feels like something is in her throat. Upon arrival to the ED care is transferred to the RN at triage.


VAERS ID: 1186261 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Discomfort, Fatigue, 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: none
Current Illness: undiagnosed intermittent tremors
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Low fever (100.1 F), body ache, exhaustion, general discomfort. Symptoms first started the evening of the vaccination day (yesterday, 04/08/21). The symptoms increased day after the vaccination (04/09/21). Patient has been in bed since last night


VAERS ID: 1186274 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 29 YO/M PT REPORTS THAT HE RECEIVED THE VACCINATION AND BECAME LIGHTHEADED. PT WIFE REPORTS THAT HE PASSED OUT FOR A SHORT PERIOD OF TIME AND STATES THAT HE NORMALLY DOES THIS WHEN HE GETS A SHOT. PT VITALS AREE ASSESSED AND WNL. PT REPORTS THAT HE IS FEELING BETTER AND DOES NOT FEEL THE NEED FOR TRANSPORT
CDC Split Type:

Write-up: None stated.


VAERS ID: 1186291 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-04-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Dry mouth, Dyspnoea, Electrocardiogram, Headache, Immediate post-injection reaction, Influenza like illness, Nausea, Pain, Pyrexia, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HTCZ 25 mg Multivitamin TUMS the night before
Current Illness: hypertension, spinal stenosis, acid reflux, plantar fibromatosis
Preexisting Conditions: hypertension, spinal stenosis and acid reflux
Allergies: milk, milk products such as whey or sodium caseinate, perfumes, antibiotics, steroids, darvon, talwin, anesthesia takes months to clear my system, omeprazole caused memory loss/decreased concentration, lisinopril caused gastric distress, seasonal such as pollen and mold and dyes
Diagnostic Lab Data: See above.
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Immediate dizziness, vertigo with nausea, dry mouth, shortness of breath, headache and increased blood pressure. Later at night I had a low grade fever with achiness and headache. The flu like symptoms resolved by morning but I continue to have vertigo and intermittent nausea and my BP was still high in the morning around 9 am but came down by 12:45 to my normal range. Paramedics at the site did a BP, pulse ox, blood sugar, ECG . Everything was normal except my BP which was 180/90. This morning it was 167/98 and 168/97. No treatment. Saw my doctor''s partner at 1:00 today and BP was back to my normal range but I still have mild vertigo and intermittent nausea. Doc gave me some exercises to do for the vertigo and did not seem to think that it was related to the shot, but since the paramedics said they had seen a LOT of the same reaction yesterday to the J&J shot and two sites in other cities shut down for the same reactions, nobody will convince me that it was anything but the shot. I expected the flu like side effects but never dreamed it would cause my BP to spike and the vertigo.


VAERS ID: 1186298 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

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

Write-up: Upon arrival subject is CAOx4. Subject is found sitting in her car, after receive her COVID vaccine. Subject stated that she would like to be checked out. Subject stated that she does not having any symptoms, but would like to double check everything is okay. Subject''s skin warm/dry, respiratory rate/ effort normal, pulse rate fast/regular, mucous membrane pink/dry. EMS note subject''s Spo2 is in the upper 90''s, subject Is noted to be tachycardic. Subject stated that she normally has a fast heart rate when she is getting an examination done. Rhythm showed Sinus Tachycardia with no significant ST elevation. Subject stated that she feels fine. Subject denied any shortness of breath, chest pain, blurry vision, headache, N/V/D. EMS monitored the subject for a moment to see if heart rate would come down. After approximately 10 minutes EMS not that subject''s heart started to come down. EMS offer transport to the hospital to the subject. Subject stated that she feels okay and does not wish to go to the hospital. EMS explains the risk of not being further evaluated. Subject stated that she understands and does not wish to go to the hospital.


VAERS ID: 1186313 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Injection site pain, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Tylenol to help with Side-Effects.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA I had a fever, headaches, nausea, fatigue, soreness on injection site, and loss of appetite.


VAERS ID: 1186328 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Throat tightness, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (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, Amlodipine, Fluoxetine, Ibuprofen, Other
Current Illness:
Preexisting Conditions: Hypertension
Allergies: Theophylline
Diagnostic Lab Data:
CDC Split Type:

Write-up: 41 YO FEMALE CONSCIOUS AND ALERT WITH A GCS OF 15 COMPLAINING OF HER THROAT FEELING LIKE IT WAS CLOSING UP. PT JUST RECIEVED HER COVID 19 VACINATION. PT DENIED CHEST PAIN, SOB, N/V/D, HEAD NECK AND BACK PAIN, BLURRED VISION, DIZZINESS. PT HAD A PATENT AIRWAY WITH EQUAL CHEST RISE AND FALL. PT HAD NO NOTED HIVES OR RASH, PT WAS EXCHANGING AIR AT 98% SATURATION. PT HAD NO OTHER NOTED DCAPBTLS, HEENT WAS UNREMARKABLE. PT VITALS WERE TAKEN AND RECORDED. PT WAS GIVEN 50 MG OF BENEDRYL PO BY PARAMEDIC. PT WAS OFFERED TRANSPORT TO THE LOCAL HOPSPITAL FOR FURTHER EVALUATION. PT REFUSED


VAERS ID: 1186354 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Body temperature increased, Headache, Heart rate increased, Injection site urticaria, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: anxiety medications, depression medications, meds for RA and fibromyalgia
Current Illness: none
Preexisting Conditions: anxiety, depression, RA, fibromyalgia, celiac disease
Allergies: wheat, hazelnuts, fresh-fruit
Diagnostic Lab Data:
CDC Split Type:

Write-up: elevated HR, lots of anxiety, hives by injection site that went away the next day. high temp of 101 the next morning, headache and whole body hurts.


VAERS ID: 1186360 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Vasovagal reaction


VAERS ID: 1186361 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Chronic pain
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: 34 YO MALE WAS COMPLAINING OF HIS LEFT ARM AND SIDE OF HIS FACE STARTED TO FEEL NUMB AFTER GETTING IS COVID 19 VACINATION. PT DENIED CHEST PAIN, SOB, N/V/D, HEAD NECK AND BACK PAIN, BLURRED VISION, DIZZINESS. PT HAD A PATENT AIRWAY WITH EQUAL CHEST RISE AND FALL. PT HAD NO NOTED SWELLING TO THE LEFT SIDE OF HIS FACE AND HAD FULL PMS AND ROM TO THE LEFT ARM. PT HAD NO OTHER NOTED DCAPBTLS, HEENT WAS UNREMARKABLE. PT VIATLS WERE TAKEN AND RECORDED. PT OFFERED TRANSPORT TO THE LOCAL HOSPITAL FOR FUTHER EVALUATION. PT REFUSED


VAERS ID: 1186366 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: Headache, followed by severe cold chills, nausea.


VAERS ID: 1186370 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Back pain, Chills, Dizziness, Headache, Myalgia, Neck pain, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women''s multivitamins, Del-Immue V, Glutathione - all 4-5 times a week Vitamin D with Vitamin K - once a week This week I was given 1 shot of cortisone in my knee joint for pain on Monday (1st time, hope to be the only time)
Current Illness: No illness, only knee pain due to injury
Preexisting Conditions: Had double mastectomy due to breast cancer in both breasts in 2018 (no chemo required) Regular migraines
Allergies: Penecillin, Ciprofloxacin All seafood - salt & fresh, shell (diff reactions for different fish)
Diagnostic Lab Data: N/A - doing self-care at home at present, assuming symptoms will pass/resolve in the next couple of days
CDC Split Type:

Write-up: About 7 hours after the shot I was slightly light-headed but not badly then started to feel pain in my left shoulder joint, then left armpit, then soreness in my neck and upper back on my left side with beginning of headache. 2 hours later I developed fever reading 100.1 and got sniffly, headache increased a lot. Lay down. Headache increased, as did muscle aches which spread to all over but stronger on left side. My left knee, which had had a cortisone shot for pain on Monday and had been hurting less since Wednesday, suddenly hurt SO much! Took ibuprofen with slight relief of aches but not much help to headache or knee pain. Have had to ice knee continually and can no longer walk without limping, more actions than usual result in pain spikes in my knee. Headache and chills/fever constant all that night, along with aches and a lot of knee pain. Next day (today) headache, fever continuing, plus left shoulder join & armpit pain, joint aches in general + lots of knee pain. Took ibuprofen again. Helped enough to do basic things. Am resting with icing knee. Will be going back to bed shortly. (It has been 28 hours since my J&J shot.) Please note: I do not normally take Ibuprofen (or Tylenol) unless desperate since it makes me nauseous.


VAERS ID: 1186373 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Fatigue, Feeling cold, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: NA
CDC Split Type:

Write-up: Vaccination + 3 hrs - Headache, Fatigue Vaccination + 8 hrs - Headache, Severe Fatigue (took over the counter Ibuprofen) Vaccination + 14 hrs - Severe Chills, Headache, Muscle Ache (took over the counter Tylenol) Vaccination + 16 hrs - Cold sweats, Headache, Muscle Ache, Fever = 103 deg F Vaccination + 20 hrs - Headache, Muscle Ache, fever = 101 deg F Vaccination + 24 hrs - Headache, Muscle Ache (took over the counter Ibuprofen)


VAERS ID: 1186376 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Blood urine, Metabolic function test, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Cold
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Full blood panel and urine sample on 4/9/2021
CDC Split Type:

Write-up: Cramping in lower abdomen and blood in urine.


VAERS ID: 1186381 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Diarrhoea, Dizziness, Headache, Nausea, Pain, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine, nifedipine, furosemide, rosuvastatin, famotidine, trazodone, montelukast, tizanidine, omeprazole, fluticosone, baby aspirin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Really bad headache, nausea, dizziness, fever, achy all over, arm swollen even in arm pit and really sore,diarrhea


VAERS ID: 1186385 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / N/A RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 accompanied by her mother who also signed consents. Vaccinated with Jansen Covid 19 vaccination and not yet 18 years old.


VAERS ID: 1186389 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

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

Write-up: 20 YO FEMALE CONSCIOUS AND ALERT WITH A GCS OF 15 COMPLAINING OF HAVING ITCHING AND HIVES TO THE LEFT FOREARM. PT WAS JUST GIVEN HER COVID 19 SHOT. PT DENIED CHEST PAIN, N/V/D, SHORTNESS OF BREATH, BLURRED VISION, DIZZINESS. PT HAD A PATENT AIRWAY WITH EQUAL CHEST RISE AND FALL. PT HAD SOME HIVES TO THE LEFT FOREARM. PT HAD NO DIFFICULTY BREATHING OR RASH ANY WHERE ELSE. PT HAD NO OTHER DCAPBTLS, HEENT WAS UNREMARKABLE. PT VITALS WERE TAKEN AND RECORDED. PT WAS GIVEN 50 MG OF BENEDRYL PO BY EMT. PT WAS OFFERED TRANSPORT TO THE LOCAL HOSPITAL FOR FURTHER EVALUATION. PT REFUSED


VAERS ID: 1186419 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Sesame Seeds
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt alert, oriented. Pt rcv''d J&J vaccine and approx 6 minutes later felt tingling in both of her hands. Pt reports hx of sesame seed allergic reaction (anaphylaxis), and she was concerned that this may progress to that point so she just wanted to be checked. Pt declines chest pain, diff breathing, dizziness, syncope, N/V, diaphoresis. Speaking in full sentences. V/S as shown. Pt remained in monitoring area until parking area was released.. Pt stated she felt better and left.


VAERS ID: 1186436 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Asthenia, Chest pain, Headache, Myalgia, Neck pain, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza vaccine, 2 years old, hospitalization required
Other Medications: Amitriptylene, metoprolol, fludrocortisone
Current Illness:
Preexisting Conditions: 2 Cardiac repairs, tracheal reconstruction, POTS, migraines
Allergies: Opiate pain killers, emitrex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe abdominal cramps, severe chest pain, neck pain and headache, severe joint pain, muscle aches and weakness and shakiness. Started 6 hours after receiving vaccine and is ongoing at 30 hours post vaccination.


VAERS ID: 1186441 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

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

Write-up: 47 YO MALE CONSCIOUS AND ALERT WITH A GCS OF 15 COMPLAINING OF FEELING NAUSEAUS. PT JUST RECIEVED HIS COVID 19 VACINATION. PT DENIED CHEST PAIN, SOB, V/D, HEAD NECK AND BACK PAIN, BLURRED VISION, DIZZINESS. PT HAD A PATENT AIRWAY WITH EQUAL CHEST RISE AND FALL. PT HAD NO NOTED DCAPBTLS, HEENT WAS UNREMARKABLE. PT VITALS WERE TAKEN AND RECORDED. PT WAS OFFERED TRANSPORT TO THE LOCAL HOSPITAL FOR FURTHER EVALUATION. PT REFUSED


VAERS ID: 1186456 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain, Blindness unilateral, Chills, Constipation, Eye haemorrhage, Headache, Immediate post-injection reaction, Insomnia, Muscle spasms, Myalgia, Nausea, Oropharyngeal pain, Poor quality sleep, Pyrexia, Sleep disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristiq 150 mg, Trazodone 100mg, Tri-Estarylla birth control
Current Illness: none
Preexisting Conditions: none
Allergies: Amoxicillin, citrus fruits
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Immediately after getting the vaccine, I experienced severe nausea for 10-20 minutes. I experienced no symptoms for 3-4 hours afterward, but then began to develop a low-grade fever, muscle aches, a headache, and became nauseous again. Around 12 hours after getting the vaccine, I developed a fever of 102 F, I began to experience severe muscle aches and cramps in my calves and abdomen. I also began to develop a much worse headache and lost partial vision in my right eye for a few hours. This is when I became violently nauseous, but I was unable to throw up, or defecate. I was unable to sleep during this time, and at 2 am, my nausea peaked, and I threw up incredibly violently and incredibly suddenly. It was so violent, it caused me to pop a blood vessel in my eye, and gave me a sore throat. However, after throwing up, most of nausea subsided. At this point, the vision began to return to my eye. 20-40 minutes after throwing up, I began to experience chills that lasted for up to an hour. Eventually, I slept at 4 am, but slept fitfully, and woke every 40 minutes to 2 hours. At 7 am on the 9th, the nausea was completely gone the day after my vaccination, but the muscle aches and headaches were back. My fever was down to 101, and I took some Tylenol and slept fitfully until 2 pm when I woke up feeling significantly better.


VAERS ID: 1186462 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Chills, Headache, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Taking singular, levothyroxine, Benadryl, estradiol, requip, nasacort,
Current Illness: Weight loss Loss of appetite Hypothyroidism 1kidney from donation
Preexisting Conditions: Hypothyroidism 1 kidney
Allergies: Tetracycline, latex, neosporin, and seasonal allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: SEVERE headache Uncontrollable shaking and chills 103 temp Body aches Weak joints and body Felt like the flu x?s 600


VAERS ID: 1186468 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Asthenia, Cervical spinal stenosis, Condition aggravated, Conversion disorder, Dizziness, Dysphagia, Fatigue, Gait inability, Magnetic resonance imaging, Malaise, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: ANXIETY, EPISODES OF ARM/LEG WEAKNESS
Allergies: INSECT VENOM, POISON IVY, SULFA
Diagnostic Lab Data: MRI
CDC Split Type:

Write-up: 48yr old female with history of anxiety, previous episodes of arm and leg weakness currently undergoing work-up for intermittent neurologic symptoms x 2yrs (on , allergies (insect venom: hives, shortness of breath; poison ivy: hives, shortness of breath; sulfa: hives) presented for COVID-19 J&J vaccine on 4/8/21. RN administered JANSSEN COVID19 VACC (LOT # 207A21A, exp 6/23/21) IM in patient''s left deltoid at 1410. Approximately 5 minutes after receiving vaccine, patient complained of dizziness which later manifested as increased fatigue, malaise, weakness of the extremities with eventual report of tingling in the face. Patient unable to ambulate. Patient transported to exam room via wheelchair and transferred


VAERS ID: 1186470 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (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: ASA, Albuterol, Plavix
Current Illness:
Preexisting Conditions: Asthma, Atrial Fibrillation, Breast Cancer, Hypothyroidism
Allergies: Morphine, Penicillin allergy, Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: 63 yo female patient complaining of a "tightness in her throat" Pt states she had multiple allergies. Pt given benadryl. No swelling to mouth or tongue noted. Pt denies any shortness of breath. Vital signs wnl. Pt stated she would sit and wait for awhile to see if she began feeling better. Pt advised she did not want to go to the hospital.


VAERS ID: 1186473 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: 16 Y/O PATIENT RECEIVED THE COVID19 (JANSSEN) VACCINE AT OUR WALK-IN CLINIC ON 4/8/21


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