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

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



Case Details (Reverse Sorted by Onset Date)

This is page 9 out of 1,889

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VAERS ID: 1273478 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: School       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: Claritin 10 mg daily, Doxycycline Hyclate 100 mg daily, Effexor XR 75 mg daily, Nuvaring
Current Illness: No acute illness
Preexisting Conditions: Depression, Allergies, Acne Vulgaris
Allergies: Amoxicillin, Erythromycin, Bananas, avocado, eggplant
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Beginning approximately 20 hours after injection, the patient developed urticaria from her forehead to toes, sparing only palms and soles of feet. She is started on a Medrol dose pack today. Taking Zyrtec 10 mg daily (hold Claritin while on Zyrtec) and Benadryl 25 MG every 8 hours as needed for itching.


VAERS ID: 1273480 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-04-12
Onset:2021-04-29
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lecithin, d3, omega3, centrum platinum, enalapril 2.5, lipitol,
Current Illness:
Preexisting Conditions: Asma, high blood preasure
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizziness heart speeding fast and a intense headache and the time.


VAERS ID: 1273563 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK UN / IM

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

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

Write-up: Patient was given the Johnson and Johnson Vaccine on 4/8/2021 and on 4/29/2021 patient received Moderna Vaccine. Patient showed no signs or symptoms of reaction of any kind. Patient denied any pain or discomfort after receiving Moderna shot.


VAERS ID: 1273801 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-29
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No tests as of yet. I have a doctor appt scheduled. Was told to put a warm cloth on it or go to ER if I felt like I needed to.
CDC Split Type:

Write-up: Left arm became very sore at spot of vaccine 19 days after shot. It feels like I was punched in the arm. There was little to no soreness after shot or anytime until 19 days after.


VAERS ID: 1273833 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Feeling cold, Headache, Neck pain, Pain, Pyrexia, Sleep disorder, Toothache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (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: Women''s one-a-day supplement, Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 7:00 PM I started feeling tired and a little cold, by 7:30 PM I had horrible body aches and chills and was very tired. I laid down to go to sleep at 8:30 PM and dosed in and out of sleep. Around 10:30 PM I had a fever of 100.7 degree Fahrenheit. Around 12 AM my fever broke and by 1:30 PM I started feeling better. I had a really bad headache all night and into the morning, so bad I could feel throbbing in my teeth. I still have some soreness in my left hip joint and shoulder/neck. I have also had diarrhea once around 12:30 PM today. I did have COVID-19 at the end of December 2020 into January 2020. Not sure if that makes a difference.


VAERS ID: 1273854 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chest pain, Chills, Dyspnoea, Fatigue, Hyperhidrosis, Hypersomnia, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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: Adderall XR 30mg Lezapro 20mg Cranberry pill
Current Illness: Nonexistent
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever, body aches, chest pains, back pain, fatigue, sweating, chills, shortness of breath, over sleeping, left arm pain.


VAERS ID: 1273863 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-13
Onset:2021-04-29
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Full blood count, International normalised ratio, Metabolic function test, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cloNIDine HCL 0.2 mg tablet TAKE 1 TABLET BY MOUTH TWICE DAILY ibuprofen as needed lisinopriL 20 mg tablet TAKE 1 TABLET BY MOUTH DAILY minoxidiL 2.5 mg tablet TAKE 1 TABLET BY MOUTH TWICE A DAY predniSONE 10 mg tablet TAKE 1 TAB
Current Illness:
Preexisting Conditions: dm2 a1c 7, htn, gout, prostate cancer in 2004
Allergies: sulta
Diagnostic Lab Data: ultrasound of the lower extremety, CBC, CMP, INR
CDC Split Type:

Write-up: DVT in left popliteal and left superficial femoral vein


VAERS ID: 1273948 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-08
Onset:2021-04-29
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Confusional state, Hypoxia, Lethargy, Pneumonia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Warfarin 5 mg po daily Rosuvastatin 10 mg po at bedtime Advair Diskus 500-50 1 puff BID Losartan 25 mg po daily Omeprazole 40 mg po daily
Current Illness: None
Preexisting Conditions: DVT/PE, prostate cancer, hyperlipidemia, COPD, non-obstructive CAD, chronic venous insufficiency, osteoporosis, hard of hearing
Allergies: Benzoyl peroxide (severe, rash and swelling) Prednisone (severe, rash and swelling) Neomycin (severe, rash and swelling) Tobramycin (intermediate, nausea and dizziness)
Diagnostic Lab Data: Chest X-ray (04/29/21) ? multifocal bilateral pneumonia COVID-19 PCR (04/29/21) ? positive
CDC Split Type:

Write-up: The patient presented to Emergency Department with lethargy, confusion, and hypoxia. Upon presentation to the ED, the patient tested positive for COVID-19 (04/29/21). The patient is currently being treated with dexamethasone and remdesivir.


VAERS ID: 1273983 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-25
Onset:2021-04-29
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray abnormal, SARS-CoV-2 test positive
SMQs:, Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Wixela, Albuterol, Diltiazem,lasix,singular, prednisone,lexapro, coumadin
Current Illness: vertigo
Preexisting Conditions: Asthma w/ COPD, HTN, recurrent DVT, a fib, TIA,
Allergies: NKDA
Diagnostic Lab Data: Positive Covid pcr 4/29 Chest Xray w/ infiltrates
CDC Split Type:

Write-up: Hospitalization w/ covid pneumonia


VAERS ID: 1273985 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Nausea-Medium


VAERS ID: 1274176 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Had taken 15mg Meloxicam prescribed by an orthopedist for a shoulder issue a little over 24 hours prior to vaccination. Otherwise, none
Current Illness: None that I know of
Preexisting Conditions: None
Allergies: None that I know of
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 10PM day of vaccination, started feeling weakness. Weakness became fever and mild headache around 11PM. Low grade fever and weakness and intense fatigue persisted into the next day, April 30th. Low grade fever still ongoing at time of this writing. Headache has mostly resolved, along with regaining some strength.


VAERS ID: 1274559 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Restless legs syndrome
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None as of now
CDC Split Type:

Write-up: Restless leg syndrome


VAERS ID: 1274611 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Fatigue, Nausea, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen, amlodipine, betamethasone-clotrimazole, cephalexin, docusil, lactobacillus, levothyroxine, lisinopril, lorazepam, metoprolol, miralax, nystatin topical, omeprazole, sertraline, zofran
Current Illness: dysphagia, UTI, pressure ulcer, vertigo, hypothyroidism
Preexisting Conditions: On hospice care for primary diagnosis of cerebrovascular disease with secondary severe dysphagia and recurrent urinary tract infections
Allergies: penicillin, sulfa, bee stings, procaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Family reported patient had fatigue, temp of 100 F, nausea, vomiting, and a seizure within 24 hours


VAERS ID: 1274617 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Asthenia, Chills, Delirium, Headache, Immediate post-injection reaction, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unithroid - 100mcg Spirnolactone
Current Illness:
Preexisting Conditions: Hashimoto''s Thyroiditis PCOS
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain immediately after injection - sore arm, whole arm felt heavy 4 hours later - headache At about 5:30pm - slight fever, slight chills 6:30pm-7:00pm - high fever, terrible chills, widespread body aches, delirium, nausea, extreme weakness, bed ridden The following day - weak, body aches, loss of taste


VAERS ID: 1274762 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, xyzal, atorvastatin, lexapro, nuvaring, biotin, multivitamin
Current Illness: None
Preexisting Conditions: Hypertension (treated)
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fainted approximately 2 minutes after injection. Woke up approximately 1 minute later and immediately vomited.


VAERS ID: 1274801 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, Headache, Hypoacusis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hearing impairment (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine at 545pm. Administration noted as normal per pharmacist (rph), pt walked to waiting area chair. Approximately 7 minutes later pt asked for water. Pharmacist brought water to pt and asked if he was feeling okay. Pt stated he was having trouble hearing the rph. Rph walked back to pharmacy and continued to observe patient. approx 2 min later, pt passed out from seated position. rph did not see fall. both technician and rph ran out to pt. pt face down and water bottle spilled. assistant store manager reported as well. pt came to immediately and sat up on floor. He attempted to stand to sit in chair, but rph asked him to remain on floor. rph went to get emergency kit while tech observed patient. rph came back with instant ice pack. First pack did not activate but second pack did and had patient hold to his head as there was a visible red spot. Patient continued to be observed and was texting on phone during observation. Patient came up to pharmacist at 6:15 to ask to leave and Rph asked if pharmacy representative to could walk him to his car. Patient denied and Rph asked him to wait additional 5 minutes for observation. After 5 minutes, patient left. Today I called patient. He said he is feeling better and still has mild pain and a headache today.


VAERS ID: 1274991 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-27
Onset:2021-04-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Parosmia, Taste disorder
SMQs:, Taste and smell disorders (narrow)

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

Write-up: I smell metallic, acidic, bitic, acerbic tastes and smells and extreme sensitivity to food.


VAERS ID: 1275537 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, amoxicillin, compazine, keflex, codeine, percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within a couple of hours, severe chills, fever, muscle and joint pain began. These are ongoing.


VAERS ID: 1275917 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chills, diarrhea


VAERS ID: 1276650 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210458827

Write-up: LITTLE LIGHTHEADED; This spontaneous report received from a patient via a company representative concerned an 83 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 27-APR-2021 for prophylactic vaccination.The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 29-APR-2021, the subject experienced little lightheaded. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from little lightheaded. This report was non-serious.


VAERS ID: 1276654 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Migraine
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: EXCEDRIN [ACETYLSALICYLIC ACID;CAFFEINE;PARACETAMOL;SALICYLAMIDE]
Current Illness: Migraine
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210458843

Write-up: SEVERE MIGRAINE HEADACHE; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included migraines. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: 21-JUN-2021) dose was not reported, administered on 28-APR-2021 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid/caffeine/paracetamol/salicylamide for migraines. On 29-APR-2021, the subject experienced severe migraine headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of severe migraine headache was not reported. This report was non-serious.


VAERS ID: 1276672 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Iowa  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Rash, Sunburn
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210458983

Write-up: POSSIBLE SUNBURN; RASH ON FACE; This spontaneous report received from a patient concerned a 42 year old female. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, administered on 28-APR-2021 14:40 for prophylactic vaccination. No concomitant medications were reported. On 29-APR-2021, the subject experienced possible sunburn. On 29-APR-2021, the subject experienced rash on face. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from rash on face, and possible sunburn. This report was non-serious.


VAERS ID: 1276675 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210459123

Write-up: INJECTION SITE PAIN; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-APR-2021, the subject experienced injection site pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of injection site pain was not reported. This report was non-serious.


VAERS ID: 1276682 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient was not pregnant at time of reporting.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210459774

Write-up: TREMBLING OF RIGHT ARM; This spontaneous report received from a patient concerned a 51 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient was not pregnant at time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 207A21A expiry: UNKNOWN) dose was not reported, administered on 29-APR-2021 16:00 for prophylactic vaccination. No concomitant medications were reported. On 29-APR-2021 22:00, the subject experienced trembling of right arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from trembling of right arm. This report was non-serious.


VAERS ID: 1277146 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-04
Onset:2021-04-29
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Chest pain, Computerised tomogram thorax, Pleuritic pain, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (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? No
Previous Vaccinations:
Other Medications: Microgestin FE 1mg-20mcg Lexapro
Current Illness: none
Preexisting Conditions: depression
Allergies: none
Diagnostic Lab Data: CT angiogram with pulmonary embolism
CDC Split Type:

Write-up: Patient presented to the emergency department with right-sided pleuritic chest pain-she has a pulmonary embolism on CT angiogram. She was started on heparin and admitted to the medical center. She received her Johnson and Johnson vaccine on 03/04/2021.


VAERS ID: 1277388 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Influenza like illness, Muscle tightness, Neck pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (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:
Other Medications: Finasteride 1mg 1x daily for hair loss prevention
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Latex, penicillin, latex fruits, most trees/fruits/vegetables.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Low grade fever Chills Body aches Neck pain Muscle tension Fatigue General flu-like symptoms


VAERS ID: 1277469 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid, Pepcid complete, Kombucha, tylenol
Current Illness: None
Preexisting Conditions: GERD
Allergies: Aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, nausea, chills, sore throat, muscle aches, tired, headache


VAERS ID: 1277515 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Mild, Systemic: Weakness-Mild, Additional Details: pt gets nervous during shots


VAERS ID: 1277531 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-27
Onset:2021-04-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Chest X-ray, Oropharyngeal pain, Pneumococcal infection
SMQs:, Supraventricular tachyarrhythmias (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (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: metformin, propafenone, levothyroxine, amlodipine, hydralazine, metoprolol, fenofibrate, xarelto, simvastatin, potassium, magnesium
Current Illness: none
Preexisting Conditions: afib, diabetes, high blood pressure, hashimotos thyroiditis
Allergies: ace inhibitor cough
Diagnostic Lab Data: chest xray at ER
CDC Split Type:

Write-up: thurs apr 29, double pneumonia, sore throat, afib episode


VAERS ID: 1277790 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-16
Onset:2021-04-29
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Dizziness, Heavy menstrual bleeding, Postmenopausal haemorrhage, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Vestibular 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: estradiol, tretinoin, OTC progesterone, turmeric, D3, Bcomplex, Quercitin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: I have already reported that I am experiencing menstrual bleeding at age 60. In addition to that, on April 29, I experienced dizziness, fever, chills, lower back pain and joint pain. The symptoms dissipated the following day. I am still experiencing menstrual bleeding.


VAERS ID: 1277804 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Intensive care, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of seizures since childhood
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was observed for at least 15 minutes. Arrived at home and had a seizure, was rushed to the hospital. Mother claimed patient is in ICU.


VAERS ID: 1277815 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Dizziness, nausea and vomiting. Only reporting for what it?s worth to cdc. All manageable but def not psychosomatic byproduct of anxiety.


VAERS ID: 1278241 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea, Presyncope, Vital signs measurement
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Vasovagal episode. After receiving dose patient complained of feeling lightheaded, nauseous and was visibly sweating. Vitals were taken 10:10 106/60 97% HR: 52. At 1015 vitals were 118/10, 98% and HR 65. Patient was given wet towels around his neck and on his forehead. brought cot to patient and patient placed in trendelenburg position. pt given water and stated he was no longer lightheaded or nauseous but continued to have HA. Pt at that time was being evaluated by both doctors. Patient then walked to monitor area where was continuously checked on until 1100 when his vitals were rechecked (118/80, 68HR). Pt stated he felt better and was released and recommended not to drive. Pt says his brother would drive him home. - RN


VAERS ID: 1279498 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Starting exactly 9 hours after injection, a headache set in, very high fever causing shivering, felt weak. Fever and shivering and weakness continued for the next 24 hours. Extreme headache continued for the next two days.


VAERS ID: 1279528 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu and pneumonia vaccine in 1995; flu like symptoms for 24 hours
Other Medications: Losartan, 100mg daily; hydrochlorothiazide, 25mg daily; Vit. D 1000 IU daily; Centrum Silver for Women, 1 tablet daily; Fiber Choice, 2 tablets twice a day
Current Illness: none
Preexisting Conditions: lichen sclerosus, eczema, hypertension (treated), breast cancer survivor 1995, colon polyps
Allergies: dexamethasone, penicillin, Suprep bowel prep, rats, and cats
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fatigue and malaise within 3 hours; chills, nausea and vomiting after 11 hours; headache, muscle aches, weakness and nausea/vomiting for 24 hours after the vaccine.


VAERS ID: 1279633 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Full blood count, Migraine, Muscle spasms, Nausea, Pain in extremity, Platelet count normal, Sleep disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Medications (very important) New medications from outside sources are available for reconciliation betamethasone, augmented, (DIPROLENE) 0.05 % ointment Apply 1 application topically 2 (two) times a day. botulinum toxin type A (BO
Current Illness: Cardiovascular and Mediastinum Sinus tachycardia Endocrine Hypothyroidism Carnitine deficiency Rheumatology Chronic interstitial cystitis Neuro and EENT Migraine Dysautonomia Narcolepsy Gastrointestinal Gastroesophageal reflux disease Genitourinary Vulvodynia Vaginitis and vulvovaginitis Behavioral and Developmental Anxiety Attention deficit hyperactivity disorder (ADHD), predominantly inattentive type Signs and Symptoms Chronic fatigue and malaise
Preexisting Conditions: see above
Allergies: Bactrim [Sulfamethoxazole-trimethoprim] Cetyl Alcohol LanolinRash Sulfa (Sulfonamide Antibiotics)Other (See Comments) Weed Pollen-short RagweedOther (See Comments)
Diagnostic Lab Data: CBC with differential PLT wnl 312 4/30/2021
CDC Split Type:

Write-up: Systemic Reaction o 7/10 pain, cramping both legs described as moderate interrupting sleep, started 7hrs post vaccine. Improved by next day. o Migraine with nausea, worse with bending over, however has chronic daily migraines, improved next morning. o 3/10 abdominal pain, resolved next morning.


VAERS ID: 1279872 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ear pain, Fatigue, Oropharyngeal pain, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Coq10, Aleve, Glucosamine, Famotidine,
Current Illness: Tooth issues (left side)
Preexisting Conditions: Tendonitis, Bursides, Arthritis, old age...
Allergies: Amoxicillin.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Besides the aches, pains and fatigue I also had a sore throat & ear ache (right side only). This is probably something underlying that my immune system was suppressing and became apparent after the vaccine, Seems to be clearing up now?


VAERS ID: 1279913 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZ1A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: Vitamin b complex, vitamin d, iron, biotin, ginko biloba, krill oil
Current Illness: None
Preexisting Conditions: Vasomotor rhinitis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brain fog within 4 hours of injection lasting approx 36 hours, fatigue 10 hours after injection, pain at site of injection off and on for 5 days, muscle ache in injection arm 18 hours after injection for 24 hours, fever of 100 24 hours after injection lasting 10 hours. Treated with fluids and rest. All symptoms resolved except pain at injection site.


VAERS ID: 1280160 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-29
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Blood bilirubin increased, Computerised tomogram abdomen, Echocardiogram normal, Hepatitis viral test negative, International normalised ratio increased, Ischaemic hepatitis, Laboratory test normal, Liver function test increased, Nausea, Ultrasound abdomen normal, Ultrasound liver, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (narrow), Haemorrhage laboratory terms (broad), Biliary system related investigations, signs and symptoms (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, atorvastatin, aspirin, bisoprolol, clopidogrel, cyclobenzaprine, duloxetine, gabapentin, glipizide, levothyroxine, lisinopril, Metformin, multivitamin, pantoprazole, trazodone
Current Illness: None
Preexisting Conditions: Coronary artery disease, peripheral arterial disease, hypertension, type 2 diabetes, obstructive sleep apnea, gastroesophageal reflux disease, hyperlipidemia, depression
Allergies: No known allergies
Diagnostic Lab Data: Rapid improvement in LFTs over the following 2 days, with AST 138, ALT 1179 2 days afterwards. Suspicion for ischemic hepatitis per GI consultation, CT abdomen/pelvis, RUQ US, porto hepatic duplex, and lab workup for causes of acute hepatitis including a viral hepatitis panel were negative. echocardiogram without source of clot. Unclear if vaccination is related but given timeline and unclear source, reporting
CDC Split Type:

Write-up: Admitted after 1 day of epigastric pain with associated nausea and vomiting, since resolved without recurrence, admitted with markedly elevated LFTs with AST 1701, ALT 2980, Alk phos 219, T bili 3.92, with mildly elevated INR to 1.2.


VAERS ID: 1280175 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None at time of vaccination.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received vaccination on 04/29/2021 and came into the pharmacy the following day (04/30/2021) at approximately 1030am with an uncontrollable arm tremor in the right arm which is where she received the injection. The patient said that the tremors began the night after receiving the vaccination around 0700pm and had continued throughout the night. She did not have any pain or noticeable swelling. The patient was advised to check in with a physician, she went to urgent care and was prescribed a muscle relaxant. Upon checking in on the patient the night of 04/30/2021 (approx.: 830pm) the arm tremor was still present but the patient did not mention any other symptoms upon asking. The pharmacy attempted to call the patient on 05/01/2021 but the patient has not responded to our message at the time that this report was filed.


VAERS ID: 1280201 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-29
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness
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: tynoal
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: like having the flue


VAERS ID: 1280344 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-27
Onset:2021-04-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Audiogram abnormal, Deafness unilateral, Ear discomfort, Head discomfort, Inflammation, Neuritis, Tinnitus
SMQs:, Peripheral neuropathy (narrow), Hearing impairment (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 125mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Was first diagnosed with Tinnitus at Urgent Care. Then did an audio test with the ENT group LA - Tarzana (Dr.), who prescribed me with Prednisone for the hearing loss and tinnitus. I was told it''s a viral reaction causing inflammation which is affecting my nerve.
CDC Split Type:

Write-up: 48 hrs after the vaccine, I experienced intense pressure in my head and then hearing loss in my left ear. By the evening on April 29, I had lost almost all hearing in my left ear and was experiencing intense ringing in my left ear and pressure in my right ear. Woke up April 30th and the symptoms were worse and had lost all hearing in my left ear.


VAERS ID: 1280747 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-29
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Vaccinated 4/10/21, fully vaccinated 4/24/21. Case became ill on 4/29 with "cold like symptoms" and tested C19+ on 4/30.


VAERS ID: 1280885 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site rash, Injection site swelling, Lymphadenopathy, Pain, Paraesthesia, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Similar itching and rash from the 1st dose of the Moderna vaccine. Happened on April 1st, 2021. 63 years old at the time. Was i
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, allergies.
Allergies: She was allergic to the Moderna COVID-19 vaccine. Aspirin, erythromycin, oranges, carrots, onions, garlic, chocolate, perfumes, pollens, molds, mildews, dust.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itching that was like pinpricks all over the body, including the ankle, face, legs, and nose in particular. (No itching at the injection site.) Developed a rash on face. These all developed within 15 minutes of receiving the vaccine. Took a benadryl to be safe shortly afterwards. Itching lasted for approximately 2 days. The rash is still about the same. There was also swelling at the injection site, plus a rash that developed at the site about a day later. Other symptoms, such as fatigue, tiredness, and achiness, seem to be more typical outcomes. Also developed a swollen lymph node under the arm that received an injection. This occurred two days afterwards.


VAERS ID: 1280953 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Erectile dysfunction, Pain
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: None
Current Illness: None.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: erectile dysfunction and body aches


VAERS ID: 1281055 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Product temperature excursion issue
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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210458918

Write-up: SYRINGE ADMINISTERED OUTSIDE SYRINGE TEMPERATURE REQUIREMENTS; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-APR-2021, the subject experienced syringe administered outside syringe temperature requirements. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of syringe administered outside syringe temperature requirements was not reported. This report was non-serious.


VAERS ID: 1281059 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210459223

Write-up: BODY ACHES; HEADACHES; FEVER; This spontaneous report received from a patient concerned a 23 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported,) dose was not reported, administered on 28-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-APR-2021, the subject experienced body aches. On 29-APR-2021, the subject experienced headaches. On 29-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from body aches, headaches, and fever. This report was non-serious.


VAERS ID: 1281061 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210459415

Write-up: PAIN AT INJECTION SITE; This spontaneous report received from a patient concerned a 63 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, and expiry: UNKNOWN) dose was not reported, administered on 29-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-APR-2021, the subject experienced pain at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pain at injection site on 29-APR-2021. This report was non-serious.


VAERS ID: 1281741 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose abnormal, Syncope, Vital signs measurement
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient received vaccine 4/29/21 at 16:45. He fainted for a short period of time during his observation time. EMS was called but patient was not transported. NKDA, no past medical history, no current medications. BP and HR were checked 4 times and all times were unremarkable. Blood sugar was checked by EMS and was 118. Patient did report having the same reaction back in college after receiving his MMR vaccine. Patient was driven home by his wife.


VAERS ID: 1282089 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Influenza like illness, Pyrexia, Sleep disorder
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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately eight hours after injection, sweeping to severe fatigue began to onset along with severe headache and moderate to severe chills, along with other "flu-like" symptoms, including symptoms of fever but no recorded fever. Lasted through the night and hindered sleep without the help of OTC sleep medication. After 8 hours of overnight sleep, woke up next day feeling better, but still had a terrible headache and a great deal of fatigue. Considered visiting a walk-in clinic or the ER at least four times throughout this timeframe. Symptoms lessened with time with a bad headache and lingering fatigue being the most consistent 24 to 36 hours after the initial injection time. Now May 3 at 1:00pm, several days after, most symptoms have subsided except for some lingering fatigue which still is present.


VAERS ID: 1282509 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pruritus, Swelling, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: PT STATED SHE EXPERIENCED VOMITTING THE DAY OF THE VACCINE IN THE EVENING. SHE ALSO STATED IT PROGRESSED OVER THE NEXT DAY INTO HIVES AND SWELLING. THE ITCHING/SWELLING/HIVES CONTINUED TO BECOME WORSE TO WHICH SHE THEN VISITED THE LOCAL EMERGENCY DEPARTMENT. THE GAVE STERIODS AND OTHER MEDICATIONS BASED ON THE PATIENTS INFORMATION. AS OF 5/3/2021 WHEN THIS IS BEING REPORTED SHE IS STILL ON A STERIOD AND IS STILL HAVING SYMPTOMS RELATED TO THE HIVES AND ITCHINESS.


VAERS ID: 1282525 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Contusion, Fatigue, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81 low dose, labetalol 100 mg 2 x day, hydrochlorothiazide 25 mg, januvia 50 mg, allopurinol 300 mg, Eliquis 2.5 mg 2 x day, Vitamin D3, B complex vitamin, lanthanum carbonate w/every meal 1000 mg, oxybutynin 5 mg 2 x day, sertralin
Current Illness: On dialysis
Preexisting Conditions: Final stage kidney disease, hypertension, type II diabetes, dialysis 3 days / week
Allergies: Toradol
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Very sore at injection site. Nauseous, extremely tired, bruising


VAERS ID: 1283019 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-30
Onset:2021-04-29
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: Patient present to ED on 5/3 with leg pain. found to have blood clot in left leg via ultrasound. started on rivaroxaban and discharged
CDC Split Type:

Write-up: Patient present to ED on 5/3 with leg pain. found to have blood clot in left leg via ultrasound. started on rivaroxaban and discharged


VAERS ID: 1283160 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-21
Onset:2021-04-29
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Malaise, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: DM2, HTN, CHF
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 58-year-old male with history of DM2 on insulin, bovine aortic valve replacement, nonischemic cardiomyopathy (unknown EF), hypertension, obesity, presented to Medical Center on 4/26/21 for left leg pain and swelling. Symptoms began about 2 days ago when he drove to visit some friends and started to " feel under the weather" hence drove back yesterday. He then had acute onset of left leg swelling and pain which prompted him to present to the ED. He was reportedly concerned about " having a clot" as he just received the Johnson & Johnson Covid vaccine this past week.


VAERS ID: 1283679 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-31
Onset:2021-04-29
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Dyspnoea, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT angiogram on 5/1/21 showing bilateral pulmonary embolism
CDC Split Type:

Write-up: Shortness of breath leading to primary care physician clinic visit. Continued shortness of breath leading to ED visit. CT angiogram done shows bilateral pulmonary embolism. Patient is currently being treated with Eliquis.


VAERS ID: 1283980 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

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

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

Write-up: R arm soreness- mild to moderate on 4/29, 4/30. Fever TMax 102 F Max on 4/29/2021, 2 PM onwards. TMax 99.7 F on 4/30/2021. Temp normal from 5/1/2021 onwards.


VAERS ID: 1284692 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, 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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210461006

Write-up: STOMACH HURTS; FEVER; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced stomach hurts, and fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the stomach hurts and fever was not reported. This report was non-serious.


VAERS ID: 1284923 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Bone pain, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Osteonecrosis (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: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: Does the patient have any allergies? :: No known allergies
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: Not measured
CDC Split Type: USJNJFOC20210459703

Write-up: BONE PAIN; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 54 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non smoker, and abstains from alcohol, and the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, expiry: UNKNOWN) dose was not reported, administered on 28-APR-2021 11:00:00 for prophylactic vaccination. No concomitant medications were reported. On 29-APR-2021, the subject experienced bone pain. On 29-APR-2021, the subject experienced fever. On 29-APR-2021, the subject experienced headache. Laboratory data (dates unspecified) included: Fever (NR: not provided) Not measured. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from bone pain, fever, and headache. This report was non-serious. This case, from the same reporter is linked to 20210459729 and 20210459724.


VAERS ID: 1285297 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 received JJ COVID 19 vaccine and had a syncopal episode 2-3 minutes later that lasted for 2-3 seconds. She complained of pain back of head and was given ice pack. There was no visible or palpable injury. She was brought to medical; observation area, VSS. She was monitored for 35 minutes and left ambulatory and asymptomatic with a friend.


VAERS ID: 1285530 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, 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: anti-histamine , vitamin C
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: PINS AND NEEDLES TINGLING, NUMBNESS ON RIGHT ARM ON AND OFF CONSISTENLY. ALSO EXPERIENCING THIS ON LEFT HAND AND LEFT LEG.


VAERS ID: 1285591 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Heavy menstrual bleeding, Menstruation irregular, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: I had chills, aches, and fatigue. I started menstruation 2 days early and have had a very heavy period with lots of clotting. Filling a super+ tampon every hour-hour and a half.


VAERS ID: 1285619 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-30
Onset:2021-04-29
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PLAN: Based on current clinical presentation and HPI, patient is presenting with pain of Lt upper arm and acute headache. Given the presentation with negative neurological exam and stable vital signs with no signs of infection to injection site, patient safe for discharge. ED precautions regarding neurological changes. Advised ibuprofen for arm pain.
CDC Split Type:

Write-up: 33 y.o. female presenting alone with complaint of Lt arm pain and intermittent headaches x 2 weeks. She is wondering if symptoms are related to Janssen COVID Vaccine that she received on 4/30 (Lt deltoid). Reports similar symptoms right after vaccination, but symptoms resolved completely. Two weeks ago, symptoms started again, including headaches and pain to Lt upper arm. No vision changes or neurological changes. Pain level at this time is zero.


VAERS ID: 1285742 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-03-31
Onset:2021-04-29
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blindness unilateral, Pharyngitis, Vision blurred
SMQs:, Agranulocytosis (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 150mg
Current Illness: none
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: MADE APPT WITH EYE DOCTOR JULY 6 2021
CDC Split Type:

Write-up: I AM EXPERIENCING BLURRED VISION ON THE LEFT EYE CURRENTLY BUT IT DIDN''T START RIGHT AWAY - ALSO EXPERIENCED A THROAT INFECTION 3 WEEKS AFTER VACCINE AND WAS PRESCRIBED ZYTROMAX ANTIBIOTIC


VAERS ID: 1286166 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-28
Onset:2021-04-29
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood potassium increased, COVID-19, Chest X-ray abnormal, Cough, Dialysis, Diarrhoea, Dyspnoea, Exposure to SARS-CoV-2, Fluid overload, Headache, Hypophagia, Nausea, Respiratory tract congestion, SARS-CoV-2 test positive, Wheezing
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pacerone Norvasc Eliquis Apresoline
Current Illness: No acute illness
Preexisting Conditions: Asthma 2016 ? Bronchitis ? CAD (coronary artery disease) 2007 s/p Cypher Diag ? Chronic diastolic CHF (congestive heart failure) (HCC) ? Dyslipidemia ? ESRD (end stage renal disease) (HCC) HD M-W-F ? Foot drop, right 12/30/2011 ? Heart disease ? Heart failure with rEF 03/25/2014 ? Hyperlipidemia ? Hypertension 2016 ? Hypothyroidism 1971 ? Pericardial effusion 03/2018 S/p pericardiocentesis & pericardial window ? Peripheral neuropathy 2003 ? Pneumonia due to organism ? Recurrent pleural effusion on left 2003 S/p pleural drain ? Type 2 diabetes mellitus (HCC) 2008 noninsulin dependent
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 73 y.o. female who presents today with multiple complaints worsening shortness of breath, cough, weakness, headache, nausea, and diarrhea. Symptoms began with a cough 3 days prior. She went to dialysis on her usual time. Sent to ER to be evaluated due to cough. Positive COVID-19 4/27. Other family members positive. Patient became progressively more weak, short of breath that she was unable to go to dialysis today. She has had poor intake with intractable nausea and diarrhea. Audible gurgling. In ER, potassium elevated and chest x-ray with congestion consistent with overload. Nephrology intending on dialysis today while inpatient. Due to poor respiratory status now requiring oxygen typically only at night. Decadron added. Not a candidate for remdesivir.


VAERS ID: 1286792 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Dehydration, Facial pain, Feeling cold, Headache, Heart rate increased, Muscle spasms, Pain in jaw, Palpitations, Pollakiuria
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Dehydration (narrow)

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

Write-up: Face pain especially jaw bones, headache, sharp shooting pain in right abdomen, icy cold, foot cramps, extremely loud and fast heartbeat for about seven hours followed by moderately loud but still very fast heartbeat for several more hours, urination approximately every half hour throughout the night resulting dehydration.


VAERS ID: 1287063 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline hyclate, Effexor, metoprolol
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin, Penicillin, Prednisone, Avocado, Banana, Eggplant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives and rash developed within 48 hours. Was prescribed Methylprednisolone pack to combat it


VAERS ID: 1287331 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-26
Onset:2021-04-29
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Pt with miscarriage at approx 7-8 weeks GA after J&J covid vaccine 3/26/21 LMP 2/27/21


VAERS ID: 1287658 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Muscle aches. Fatigue.


VAERS ID: 1287945 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Emotional distress, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Menopause
Preexisting Conditions: Comments: Menopausal
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210502453

Write-up: EXTREME ABDOMINAL PAIN; VOMIT SEVERAL TIMES; 12 HOURS OF DISTRESS; NAUSEA; This spontaneous report received from a patient concerned a 48 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included menopause. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-APR-2021, the subject experienced extreme abdominal pain. On 29-APR-2021, the subject experienced vomit several times. On 29-APR-2021, the subject experienced 12 hours of distress. On 29-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the nausea, extreme abdominal pain, vomit several times and 12 hours of distress was not reported. This report was non-serious.


VAERS ID: 1288534 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-28
Onset:2021-04-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014-C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Headache, Mental impairment, Myalgia, Nausea, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: CALCIUM; FOSAMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Cant think; Pain in arm; Fuzzy head; Arm pain,achy and everything,bodyache; slight headache; chills; feeling nauseous; This spontaneous case was reported by a consumer and describes the occurrence of MENTAL IMPAIRMENT (Cant think) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014-C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in January 2021. Concomitant products included CALCIUM and ALENDRONATE SODIUM (FOSAMAX) for an unknown indication. On 28-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Apr-2021, the patient experienced MENTAL IMPAIRMENT (Cant think) (seriousness criterion medically significant), PAIN IN EXTREMITY (Pain in arm), FEELING ABNORMAL (Fuzzy head), MYALGIA (Arm pain,achy and everything,bodyache), HEADACHE (slight headache), CHILLS (chills) and NAUSEA (feeling nauseous). At the time of the report, MENTAL IMPAIRMENT (Cant think), PAIN IN EXTREMITY (Pain in arm), FEELING ABNORMAL (Fuzzy head), MYALGIA (Arm pain,achy and everything,bodyache), HEADACHE (slight headache), CHILLS (chills) and NAUSEA (feeling nauseous) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication includes Liver supplement (herb). Treatment information was not reported. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1288691 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Vermont  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature, Fatigue, Headache, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Skin injury
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210502; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210506788

Write-up: SORE THROAT; HEADACHE; FEVER; FATIGUE; STOMACH PAIN; BODY ACHES; RIGHT LEG SORE AROUND KNEE; LEFT ARM SORE; This spontaneous report received from a patient concerned a 23 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 29-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-APR-2021, the subject experienced left arm sore. On 30-APR-2021, the subject experienced stomach pain. On 30-APR-2021, the subject experienced body aches. On 30-APR-2021, the subject experienced right leg sore around knee. On 30-APR-2021, the subject experienced fatigue. On 02-MAY-2021, the subject experienced sore throat. On 02-MAY-2021, the subject experienced headache. On 02-MAY-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the left arm sore, fatigue, headache, right leg sore around knee, body aches, fever, sore throat and stomach pain was not reported. This report was non-serious.


VAERS ID: 1288899 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Flushed / Sweating-Severe


VAERS ID: 1289095 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-29
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Electrocardiogram normal, Hyperhidrosis, Malaise, Pain in extremity, Pallor, Paraesthesia, Ultrasound scan normal, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Vicadine slight allergy
Diagnostic Lab Data: Ultra sound on left leg,-no blood clot Labs, blood work-all normal EKG-at time all normal
CDC Split Type:

Write-up: Having lunch on 04/29/21, around 11:30 am. Talking with co-worker started noticing by vision went blurry. My hands & feet started tingling. I turned very pale in facial color. Had co worker call 911, paramedics to me to ER. All my vitals showed normal, ekg, blood work, platlet count all good !! Went home and over next few days felt a little off, made regular doctor appt. follow up. Doctor said all my vitals look normal. Not sure what the cause is, had a ultra sound done of my left leg pain also. Showed no blood clots. Waiting for a heart monitor appt. On 05/03/21 woke up at 3 am drenched in sweat. Still feel a little off, for no reason . At times I feel like I might pass out. Had epilepsy as a you child. But out grew with medications. No seizures in 40 years.


VAERS ID: 1289109 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Glassy eyes, Hyperhidrosis, Slow speech, Somnolence, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: 27yo male vaccinated with Janssen covid vaccine. Within minutes of standing up from vaccination in the vaccine booth, stated he was dizzy. I sat him down immediately, he was having trouble staying awake eyes glossing over, speech very slow. I turned to push the door open into the main pharmacy to call for help and have them dial 911, grabbed epinephrine and ammonia salts as well. When I turned back he had slumped in his chair. As I took the step back towards him, he spontaneously started to sit up and speak. Was diaphoretic, still slow speech eyes glossy. I supported him as best I could. His HR was 42, i lifted his legs up unto to a chair in quazi trandelenburg position. He stated that made him feel alot better. I stayed with him until EMTS arrived. He got himself onto they stretcher and they took him out of the store.


VAERS ID: 1289783 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-07
Onset:2021-04-29
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Intensive care, Pulmonary thrombosis, SARS-CoV-2 test positive
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed COVID symptoms for a "few" days. Called his physician who referred him to the local hospital for suspected COVID. Tested positive for COVID at the hospital and blood clots in the lungs were discovered by CT scan. Patient was admitted to ICU for treatment. Details reported to VAERS by hospital and the Health District


VAERS ID: 1290297 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20SA21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Expired product administered, Fatigue, Incorrect dose administered
SMQs:, Medication errors (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Informed via phone call by the pharmacy owner shortly after returning home from the vaccine appointment that I was not only given the Moderna vaccine instead of the Johnson & Johnson vaccine, but was given expired Moderna that was supposed to have been discarded on Monday, 4/26/2020. Was told that an intern employed by the pharmacy made the mistake and that the Moderna vaccine given to me (as well as my husband and father) had been drawn into syringes on Monday 4/26/2020 and had been stored in syringes at room temperature since. Pharmacy owner had no idea of the risks involved in giving us the vaccine under such circumstances. I proceeded to call the Moderna hotline but the representative was not able to provide us with any answers, and only directed us to discuss with our healthcare professionals. Following receipt of the expired vaccine, I experienced side effects including relatively mild chills throughout the night, as well as strong fatigue the entire next day. Due to the side effects experienced, I would like to know what the estimated efficacy level was of the vaccine at the time administered, which would be able to inform me how long I have to wait to receive the Johnson and Johnson vaccine, and what risks there were (including potential microbial growth on the syringe) in receiving the expired Moderna vaccine under these circumstances.


VAERS ID: 1290340 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-29
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram normal, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: Mydayis 50mg, Atomoxetine 100mg, Bupropion 450mg, Metformin 1G
Current Illness: None
Preexisting Conditions: Pre-diabetes, now under control
Allergies: None
Diagnostic Lab Data: CT Scans with and without IV contrast
CDC Split Type:

Write-up: Developed Bell''s Palsy on morning of 4/29, with left side of face paralyzed. Was examined by emergency room physicians for stroke and blood clot, cleared and given prescription for Valacyclovir 1GM (3x day 7days) and Prednisone 50mg (1x day 5 days). As of 5/5 condition has improved significantly, though paralysis around mouth and neck areas persists.


VAERS ID: 1291616 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-09
Onset:2021-04-29
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Corneal reflex decreased, Hypoaesthesia, Paraesthesia, Taste disorder
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Corneal disorders (narrow), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Numbness of left cheek; Tingling of left cheek; Blinking abnormality/blink was hard, blink was prolonged; Change in taste; Bell''s Palsy; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of HYPOAESTHESIA (Numbness of left cheek), PARAESTHESIA (Tingling of left cheek), CORNEAL REFLEX DECREASED (Blinking abnormality/blink was hard, blink was prolonged), TASTE DISORDER (Change in taste) and BELL''S PALSY (Bell''s Palsy) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Apr-2021, the patient experienced HYPOAESTHESIA (Numbness of left cheek) (seriousness criterion intervention required), PARAESTHESIA (Tingling of left cheek) (seriousness criterion intervention required), CORNEAL REFLEX DECREASED (Blinking abnormality/blink was hard, blink was prolonged) (seriousness criterion intervention required), TASTE DISORDER (Change in taste) (seriousness criterion intervention required) and BELL''S PALSY (Bell''s Palsy) (seriousness criterion medically significant). At the time of the report, HYPOAESTHESIA (Numbness of left cheek), PARAESTHESIA (Tingling of left cheek), CORNEAL REFLEX DECREASED (Blinking abnormality/blink was hard, blink was prolonged), TASTE DISORDER (Change in taste) and BELL''S PALSY (Bell''s Palsy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. There were no further change in the patient''s symptoms since 29-Apr-2021. The patient was prescribed prednisone 60 mg for 7 days. The patient had no medications prior to development of symptoms. The concomitant medications were not provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1294086 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: General physical condition normal, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Body aches/ Over all pain; Headache; This spontaneous case was reported by a consumer and describes the occurrence of GENERAL PHYSICAL CONDITION NORMAL (Body aches/ Over all pain) and HEADACHE (Headache) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 29-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Apr-2021, the patient experienced GENERAL PHYSICAL CONDITION NORMAL (Body aches/ Over all pain) (seriousness criterion medically significant) and HEADACHE (Headache) (seriousness criterion medically significant). At the time of the report, GENERAL PHYSICAL CONDITION NORMAL (Body aches/ Over all pain) and HEADACHE (Headache) outcome was unknown. The patient was having body aches, headache, over all pain and still on going as of 30 Apr 2021. No concomitant medication No treatment medication Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1266103 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-27
Onset:2021-04-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Influenza
SMQs:, Infective pneumonia (broad), Opportunistic infections (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: Deaf in left ear
Allergies: Lactose intolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu symptoms


VAERS ID: 1266111 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-22
Onset:2021-04-28
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Injection site rash, Injection site warmth, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish Oil, Estropause, Vit D, Acidophilus
Current Illness:
Preexisting Conditions:
Allergies: Penicillin, Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red hot rash around area of injection.


VAERS ID: 1266113 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-20
Onset:2021-04-28
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pruritus, Injection site swelling, Injection site warmth, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Bupropion, Adderall, Duloxetine, Flonase, Azelastine
Current Illness: None
Preexisting Conditions: Depression, fatigue
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Small - dime-sized - raised welt at injection site. Area is warm to touch and mildly itchy. Only other side effect was arm soreness for 3 days after injection.


VAERS ID: 1266115 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-27
Onset:2021-04-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Herpes simplex, 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), Opportunistic infections (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, Zoloft, Buspar, Valtrex
Current Illness:
Preexisting Conditions: Wolf Parkinson?s White Pattern
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, headache, nausea, fatigue, HSV1 and HSV2 outbreaks


VAERS ID: 1266116 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-17
Onset:2021-04-28
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Goitre, Thyroid pain
SMQs:, Hypothyroidism (broad), Hyperthyroidism (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: Calcium supplements, fish oil, B 12
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Enlarged, sore thyroid gland


VAERS ID: 1266146 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-27
Onset:2021-04-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 LA / IM

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

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

Write-up: Muscle aches, fever, sleeplessness, fatigue


VAERS ID: 1266254 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-28
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth, Myalgia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: YAZ, sublingual b12
Current Illness: No
Preexisting Conditions: No
Allergies: Birch allergy (raw apples, peaches, plums, cherries, other stone fruits), cat dander
Diagnostic Lab Data:
CDC Split Type:

Write-up: 11 days after the injection a large red patch appeared suddenly around injection site after lifting something heavy. It is hot to the touch, swollen and slightly itchy. The muscle feels tender and sore. Patch is about 2.5 inches in diameter.


VAERS ID: 1266292 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no meds on file pt states he gets allergy shots but he hasnt had one in at least a year
Current Illness: no illness pt felt fine when he came in
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: pt said he didnt feel like himself and had some dizziness 5 minutes following administration. 10 minutes following vacc. pt had some sweating/perspiration at his brow . 15 minutes post vacc pt began feeling better on a scale form 1-10 from peak of reaction pt states he was about an 8. I continued to check in on patient and eventually walked him through the store and released patient. pt was under observation for 1/2 hour following vacc. and left facility at a 10 ie how he was feeling compared to pre vacc state (10 when he walked in 10 when released from post vacc. observation


VAERS ID: 1266319 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

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

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

Write-up: Pt administered Pfizer dose to right deltoid. Pt received moderna first dose 3/11/21 at Walgreens. Pt denies any signs and symptoms of adverse reaction. Pt observed 30mim post injection, given information on reporting to state of Az health services. VAERS filed for incident by vaccination charge. Pt educated on sign and symptoms of severe reaction and when to seek medical care upon exiting POD. Advised pt to contact for advice on vaccination status. Pt left in POV on own accord.


VAERS ID: 1266320 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

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

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

Write-up: PATIENT RECEIVE A PFIZER COVID-19 VACCINE BEYOND USE TIME OF 6 HOURS BY MISTAKE. NO ADVERSE EFFECTS HAS BEEN REPORTED AFTER RECEIVING THE ABOVE INVALID DOSE.


VAERS ID: 1266337 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / UNK - / SYR

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

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

Write-up: Pt. had first vaccine at 14:55. Pt. walked to observation one where she fainted upon arrival. Pt. was CAOx3 after she was laid down. Pt. was transferred to the back via wheelchair where she was observed for 15 minutes without any further complications. After 15 minutes patient walked out without any obvious difficulties.


VAERS ID: 1266338 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Fear of injection, Hyperhidrosis, Loss of consciousness, Pallor, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was visibly nervous prior to receiving the vaccine. About 5 minutes after administration (during the 15 minute watch period), patient appeared to be slumped over in the chair. He had eyes closed and seemed to be shaking slightly. Pharmacist and tech grabbed the emergency kit and laid patient on the floor. After a few more seconds the patient woke up and was able to respond to questions. He was very pale, sweaty, reported feeling clammy and dizzy. Patient claimed he had not eaten since the morning. We gave him some water and a pb&j sandwich. Patient stated he felt better and he just gets very nervous around needles. The patient sat with us for another 30 minutes until his grandmother and cousin were able to come pick him up from the pharmacy.


VAERS ID: 1266354 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Altered state of consciousness, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient received vaccine in clinic around 10:20am. Patient waited around the pharmacy for around 20 min and then left. Patient returned around 11-11:10 am with his mother in which we were notified that he was having a reaction. We brought the patient into the patient care room in which he was vomiting and patient''s mother stated that he had a seizure. Patient was conscious but had some altered mental status. Patient denied any falls. 911 was called and EMS took patient to the hospital.


VAERS ID: 1266362 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

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

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

Write-up: The patient had a vaso/vagal reaction with a 10 second loss of consciousness. Placed the patient on his back. He regained consciousness, I had the patient drink some orange juice after he was feelinig better.


VAERS ID: 1266366 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-27
Onset:2021-04-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Pain, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swelling
Other Medications: Neurotic, Effexor xr, levothyroxine, claritin, BusPIRone, aspirin, vitamin c, calcium w/vitamin d, ativan, omeprazole, acidophilus, meloxicam, potassium, penicillin, vitamin b
Current Illness: Upper respiratory infection
Preexisting Conditions: Fibromyalgia, endometriosis, anxiety, depression, thyroid condition
Allergies: Tetracycline, morphine, bleach, bee stings, mosquitos, seasonal allergies, dust
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Left arm pain to the point of unable to use it


VAERS ID: 1266368 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

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

Write-up: PATIENT REPORTED FEELING LIGHT HEADED. HE HAD SYNCOPAL EPISODE WITH OBSERVER PRESENT FOR 2-3 SECONDS. HE ALSO REPORT FEELING NAUSEA WITH SWEAT. HE HAD A HEART RATE 63 WITH OK PULSE . HE HAS NOT TAKEN ANY MEDICATION , NO ALLERGIES. PATIENT WAS ADVICED TO LIE FLAT WITH FEET ELEVAT AND STAY HYDRATED. PATIENT ADVICED TO NOTIFY IF NO IMPROVENT IN SYMPTOMS. WHEN SYMPTOM NOT IMPROVING, HE WAS BROUGHT TO THE TENT. BP:127/87 HR :55 . PATIENT REPORTED IMPROVEMENT IN NAUSEA, DIZZINESS AND BY 13:20PM . AT 13:27 , PATIENT LEFT WITH WIFE AFTER SYMPTOM WAS RESOLVED


VAERS ID: 1266373 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO175 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Type 1 diabetes
Preexisting Conditions: Type 1 diabetes
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt. C/O feeling light-headed and nauseated while sitting at the observation hall. She vomited some undigested food particles after sipping some fruit juice offered by her mother. Writer to her in a wheelchair to the cubicle in the observation hall for further observation. V/S T. 97 degrees fahr. b/p 97/68, rr 14, h rate 85, O2 98% RA. Pt was verbal, A&Ox4. No c/o pain or respiratory distress. At 3:10 p m pt. said she felt well and okay to leave. v/s - b/p 100/77, heart rate 80, O2 98% RA. She left the observation hall in the company of her mother unassisted


VAERS ID: 1266379 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 sitting in waiting area after receiving first dose of COVID19 vaccine. She began to feel like she might pass out. Patient was laid on the floor. Other symptoms reported included hot and sweaty and nauseous. Patient was observed in the waiting area for longer until she felt better.


VAERS ID: 1266383 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: nose bleeding for 15-- 20 minutes


VAERS ID: 1266392 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:1956-04-25
Onset:2021-04-28
   Days after vaccination:23744
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Hypoaesthesia, 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: Methadone
Current Illness:
Preexisting Conditions: neuropathy
Allergies:
Diagnostic Lab Data: None ..Doctor wasn''t concerned..He said everyone has different side effects
CDC Split Type:

Write-up: My neuropathy / burning/ pins and needles in my legs has got 10 times worse since the 2nd vaccine. I also have some numbness and tingling in my left foot I never had.


VAERS ID: 1266428 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Itching near site of Injection. Itching then spread down the arm to the elbow area. Itching on neck and side of face. Itching also on back and legs. Itching persistent for 30+ minutes


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