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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 95 out of 1,889

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VAERS ID: 1195938 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0411A21A / 1 - / SYR

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

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

Write-up: Extreme headache, extreme fatigue, blinding headache. Had COVID back in Nov 2020 and it truly felt like I had full blown COVID again.


VAERS ID: 1195943 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis, Injection site pain, Musculoskeletal stiffness, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament 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: Estroven - Menopause Relief
Current Illness: No.
Preexisting Conditions: No.
Allergies: Penicillin
Diagnostic Lab Data: No.
CDC Split Type:

Write-up: Chills - This is the first symptom I noticed. I received the shot around 3:30pm and by 7-8pm that night I started to get chills/sweats. That lasted for about a day and a half. Pain at the injection site - on day three and it is now a slight pain/soreness. Headache - lasted two days. Very Tired - lasted about two days. Muscle aches and stiffness in neck - lasted about two days. Nausea - was mostly on the second day after shot when I noticed it the most.


VAERS ID: 1196008 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Nausea, Pain, 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: Citalopram, nuvaring
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vomiting starting at 9:15 pm on/off through 11:30 pm. Attempted to take pepto at 10:00 pm and promptly threw that up too, had chills during this period, used layers and a heating pad to warm up, was dizzy at 2:40 am on 04/10, lasted into 04/10. Had body aches on 4/10 as well as a mild headache. Felt nauseous throughout the 4/10-4/11 weekend, and experienced odd stool during this time as well.


VAERS ID: 1196046 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Peripheral swelling, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncope, Arm swelling size of football


VAERS ID: 1196051 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Feeling cold, Impaired work ability, Mobility decreased, Nausea, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After Flu vaccine generalized achiness
Other Medications: Calcium Magnesium Cinnamon
Current Illness: no
Preexisting Conditions: none
Allergies: strawberries sensitive to percocet
Diagnostic Lab Data: Just notified my primary doctor No test ordered, yet
CDC Split Type:

Write-up: 5 hours after administration chills. Six hours after violently shaking, unable to get warm. Seven hours later temp 104.2 degrees on mercury thermometer and 103.8 on digital. Tylenol taken. Eight hours later unable to move due to shivers and shaking. Husband and son believe should go to hospital, I did not lose consciousness so refused. Saturday 1AM temp not budge took Advil 400 mg by 0600 temp to 102. All day Saturday taking Advil 400 mg every 5 hours temp 102 and feeling wiped out. Sunday able to move around temp 101 with Advil. Monday AM temp 100 with out Advil-need to take day off of work. And since vaccination have had a feeling of nausea I can''t shake. Today -three days later able to eat some but nausea continues.


VAERS ID: 1196127 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: mild hypertension and mildly elevated cholesterol
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 12 hours after vaccine experienced headache, nausea and injection site pain. Symptoms gradually resolved with Motrin 1600 mg/day and full recovery by 6 pm 4/11,


VAERS ID: 1196151 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Urosepsis
SMQs:, Accidents and injuries (narrow), Sepsis (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ARIPiprazole 10 MG Every Day Oral MORNING (Take 1/2 tablet to make 5 mg) 6/29/2018 3 ARIPiprazole 20 MG Every Day Oral MORNING (to be taken with 5 mg for a total daily dose of 25 mg. 6/29/2018 6 Clopidogrel 75 MG Every Day Oral
Current Illness: 11.0 Hypertensive heart disease with heart failure I50.22 Chronic systolic (congestive) heart failure E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy M47.816 Spondylosis w/o myelopathy or radiculopathy, lumbar region M47.812 Spondylosis w/o myelopathy or radiculopathy, cervical region G89.29 Other chronic pain I42.8 Other cardiomyopathies R30.0 Dysuria G47.33 Obstructive sleep apnea (adult) (pediatric) K58.9 Irritable bowel syndrome without diarrhea E66.9 Obesity, unspecified Charcot foot
Preexisting Conditions: 11.0 Hypertensive heart disease with heart failure I50.22 Chronic systolic (congestive) heart failure E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy M47.816 Spondylosis w/o myelopathy or radiculopathy, lumbar region M47.812 Spondylosis w/o myelopathy or radiculopathy, cervical region G89.29 Other chronic pain I42.8 Other cardiomyopathies R30.0 Dysuria G47.33 Obstructive sleep apnea (adult) (pediatric) K58.9 Irritable bowel syndrome without diarrhea E66.9 Obesity, unspecified Charcot foot
Allergies: Vancomycin HCL, Penicillin''s
Diagnostic Lab Data: Information at Hospital
CDC Split Type:

Write-up: Received vaccine #2 04/08/2021. Fell at home 04/09/2021 and was transferred to ER and they admitted her to hospital for Urinary Sepsos.


VAERS ID: 1196189 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN OU3A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Hyperhidrosis, Hypersomnia, Neck pain, Oropharyngeal pain, Pain, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Woke up 12 hours after vaccine shivering uncontrollably. Got several blankets and dozed back off to wake up a couple hours later dripping in sweat. My body ached the day after the shot and then the evening after is when my symptoms became more severe. I was extremely tired and my entire body hurt. It hurt to even touch my hair, lay in bed, stand, and be covered up by blankets. The following day I just felt tired and my arm was sore. Three days after my vaccine I woke up with a sore throat and neck, but just on the left side. I slept the majority of the day and my body felt achy all day. Four days after my vaccine I woke up again shivering uncontrollably and my body felt sore all over.


VAERS ID: 1196239 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Gait inability, Hypoaesthesia, Immunoglobulin therapy, Inflammation, Magnetic resonance imaging abnormal, Myelitis, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Started on 4/9/21 (1 day post vaccination) with lower back pain and impaired ability to walk. Progressed to numbness and pain in the lower extremities. Unable to walk. Presented to the Emergency Room on 4/10/21 and was admitted. MRI showed inflammation in spinal cord. Treated with IVIG and IV steroids. Diagnosed as myelitis. Remains hospitalized and scheduled for spinal tap 4/12/21


VAERS ID: 1196242 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness
SMQs:

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

Write-up: normal flu like symptoms that night


VAERS ID: 1196252 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dry mouth, Dysgeusia, Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: osteoporosis, arthritis
Allergies: clindamycin, codeine, erythromycin, pcn
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient reported about an hour after the injection she developed a dry mouth, lip felt swollen, and she had a metallic taste in her mouth.


VAERS ID: 1196306 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: Janssen COVID-19 Vaccine EUA Injection site redness, swelling, pain, warm to touch Headache, very tired, body aches


VAERS ID: 1196318 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Muscle spasms
SMQs:, Dystonia (broad)

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

Write-up: Severe Chills, Temp of 102, muscle spasms in back, and minor headache Lasted for several hours in the evening following vaccination. Needed to sleep in a heated blanket for a few hours. Took NyQuil for symptoms relief and sleep aid. The headache persisted for additional 24 hours (36 hours from vaccination)


VAERS ID: 1196347 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aphasia, Blood pressure decreased, Dizziness, Eye movement disorder, Immediate post-injection reaction, Loss of consciousness, Nausea, Pruritus
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient passed out immediately following injection of vaccine. Her eyes rolled back and she was not able to speak. The vaccinator got help immediately, and patient''s husband was in the room. She remained in a seated position with her husband holding her head up while standing behind her. Her blood pressure dropped to 78/80, heart rate was 45 bpm. She was unconscious for approximately one minute and 30 seconds. 911 was called immediately and she was transported to medical center. When I called the patient today, she did say that she was feeling better. She mostly felt nauseous and dizzy following her vaccination. She reports that her arm still feel itchy and that she has been taking Benedry


VAERS ID: 1196380 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Joint swelling, Mobility decreased, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Right Elbow pains within 7 hrs after shot. Next day elbow and right hand swollen and throbbing pain. still swollen and can not bend all the way 3 days later.


VAERS ID: 1196389 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Fatigue, Headache, Pyrexia, Tinnitus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Shortness of breath, cough, fever, chills, headache, ringing ears, extreme exhaustion


VAERS ID: 1196391 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine 10 mg 1 po qd
Current Illness: none
Preexisting Conditions: blood pressure
Allergies: none
Diagnostic Lab Data: na
CDC Split Type:

Write-up: swelling in left elbow/ pain


VAERS ID: 1196420 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Head injury, Limb discomfort, Musculoskeletal stiffness, Pain in extremity, Paraesthesia, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament 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: Buproprion; esticlapram; Gabapenton;
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm felt thick and stiff; fingers on same side began to tingle; became dizzy; sweaty; got up to ask for help as instructed, fainted and hit the top on my head on the counter, I believe; came to; threw up; laid on the floor for a while; moved to a chair; wife came to pick me up; slept for 2 1/2 hours after that; felt better in the evening; typical sore arm


VAERS ID: 1196437 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: Fever 100.8, chills, headache, complete body aches, extremely tired


VAERS ID: 1196444 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-04-09
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19 pneumonia, Mechanical ventilation, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Respiratory failure (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: morbid obesity Type 2 DM Asthma HTN
Allergies:
Diagnostic Lab Data: 4/5/2021 SARS CoV2 RNA PCR positive test
CDC Split Type:

Write-up: Patient admitted 4/9/2021 to hospital and required mechanical ventilation the next day for Covid-19 pneumonia


VAERS ID: 1196460 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever, age ~30, Yellow Fever
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, fever, chills.


VAERS ID: 1196468 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Deafness, Haemorrhage intracranial
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, atorvastatin, bromocriptine, clonazepam, duloxetine, genotropin injection, hydrocortisone, levothyroxine, potassium chloride, testosterone
Current Illness: prior intraparenchymal hemorrhage, hypopituitarism, growth hormone deficiency, prolactinoma, hyperlipidemia, BPH
Preexisting Conditions: prior intraparenchymal hemorrhage, hypopituitarism, growth hormone deficiency, prolactinoma, hyperlipidemia, BPH
Allergies: clopidogrel (prior intracranial hemorrhage_
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day after his second Pfizer vaccine, he developed hearing loss and had a CT scan of head that showed a large temporal lobe intracranial hemorrhage


VAERS ID: 1196476 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Chills, Dizziness, Dyspnoea, Headache, Hypersomnia, Loss of consciousness, Monoplegia, Musculoskeletal stiffness, Paraesthesia, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: -zoloft -hydroxyzine -B12 -Iron
Current Illness:
Preexisting Conditions: -ovarian cysts -anxiety disorder
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: -4 PM: intense headache -11:30 PM chills, uncontrollable vomiting -1:00 AM dizzy, fading consciousness, full-body tingling, paralysis and stiffness of legs, difficulty breathing -2:30 AM entered ER: blood tests, Tylenol, 2 IVs -7:00 AM discharged from ER -symptoms persisted the next two days, slept most of the day


VAERS ID: 1196479 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Chest pain, Decreased appetite, Dyspepsia, Fatigue, Hallucination, visual, Headache, Nausea, Oropharyngeal pain, Sleep disorder
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Off and on skin rashes and previous multiple skin cancers
Allergies: Coedine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Returned home around 4:30 PM from vaccine and felt a bit tired & not hungry for dinner. Iced my arm and took 2 Tylenol as my head began hurting. I went to bed at 9:00 PM and woke up around 1:00 AM with an excruciating headache and felt nauseous I took 2 more Tylenol, but could not fall back asleep. I felt very nauseous and was unable to go back to sleep. Oddly, I was sitting up wide awake and for a period of about 30 minutes, I began seeing brightly colored images that looked like they were floating in front of me. It was extremely odd as my eyes were open and I was awake. I finally fell back asleep around 5:30 AM and had horrifying vivid nightmares. When I woke up around 8:00 AM my headache was still there and I felt somewhat nauseous but not as bad as during the night. My headache continued through the day on Saturday and I continued to take Tylenol about every 6 hours. I attempted to go to bed around 9 PM when I experienced horrible chest pain that radiated through my chest and into the left side of my throat. This was frightening because the pain did not let up for 7 to 8 hours, even after taking a Tagamet. I''ve never suffered from heartburn previously other than when I was 8 months pregnant with twins. I was lucky to have any medication at home and that was only because my husband suffered from heartburn frequently. I finally fell asleep around 6:00 am for just a few hours and woke up feeling tired, but no headache or chest pain. Other than feeling tired, the symptoms appeared to all be gone. On a positive note, my arm never became sore!


VAERS ID: 1196483 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Injection site erythema, Injection site pruritus, Injection site swelling, Pain, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: Sertraline, loestrin FE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense full body aches, starting 10 hours after shot. Fatigue, weakness. Chills. Fever. Heart racing. Body aches and fatigue lasted 24 hours. Chills and fever lasted 12 hours. Redness, swelling, and itchiness at injection site starting 48 hours after shot.


VAERS ID: 1196506 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dry mouth, Headache, Oral mucosal blistering, Peripheral swelling
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Headache, chills for 10 hours, dry mouth, left arm slight swelling had to remove my fit bit and rings for 24 hours, tired 36 hours, blister on roof of mouth finally going away (day three),


VAERS ID: 1196524 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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

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

Write-up: Vomiting, headache (felt like my brain was melting), high fever, chills I couldn?t control.


VAERS ID: 1196555 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

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

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

Write-up: Severe chills, uncontrollable shivering, fever about 6 hours after vaccination. Then the next day experienced nausea, headache, mild body aches, mild fever. Aspirin and acetaminophen were taken for the fever. Symptoms has mostly subsided by the morning of April 11th.


VAERS ID: 1196579 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Back pain, Chills, Feeling of body temperature change, Headache, Heart rate increased, Hyperhidrosis, Muscle spasms, Neck pain, Pyrexia, Sleep disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Around 5:00 PM the day I got the shot I started to get a slight headache. Shortly after the headache appeared I started to get the chills, I was wrapped up in multiple blankets and started shaking uncontrollably. I then checked my temperature and at this time it was 100.3. I then ate dinner and decided to try and fall asleep. When I lied down my heart began to beat very fast. I tracked my heart rate via a watch and my resting heart rate was around 140 bpm. My fever had also increased to 102. My head ache continued to get worse and I began to have bad neck and lower back pains. I was also having muscle spasm in my calfs. The entire night I could barely sleep because of my high heart rate, body aches, shakes, and the constant change from freezing cold to hot and sweating.


VAERS ID: 1196606 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / N/A RA / IM

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

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

Write-up: Person under the age of 18 was inadvertently vaccinated with Janssen Covid-19 vaccine. No adverse effects were noted.


VAERS ID: 1196630 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Na
CDC Split Type:

Write-up: Fever (reached 101.0), chills and aches.


VAERS ID: 1196669 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Disorientation, Dizziness, Feeling abnormal, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Jansen COVID-19 Vaccine EUA Since vax on Friday April 9th: - extremely lightheaded, fuzzy, dizzy and disoriented, would describe similar to vertigo - fever on off, less frequent Sunday and Monday (today April 12) - racing heart (fri night after vax, resting heart rate over night at 70+, normal RHR 48) - anxiety


VAERS ID: 1196697 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chest discomfort, Fatigue, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Other ischaemic heart disease (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: Gabapentin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Heart palpitations, tightness in chest by heart, sharp pain on heart, extreme fatigue


VAERS ID: 1196756 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: School       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: syncope with shots, blood draws
Other Medications: none
Current Illness: denies
Preexisting Conditions: anxiety
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncope


VAERS ID: 1196767 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Computerised tomogram neck, Dizziness, Dyspepsia, Dysphagia, Feeling hot, Flushing, Heart rate increased, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypersensitivity (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C 500mg Zinc 15 mg Magniesum 250mg Calcium 500mg Vitamin D3 10,000 iu Pepcid AC 10mg Marshmellow root (herbal tea) Ginger and Chamomile (herbal tea)
Current Illness: 3 weeks before vaccination common cold symptoms, lasted 1 week, covid tests negative
Preexisting Conditions: Beta-thallasemia minor, osteoporosis, fatty liver, Sleep apnea, excessive daytime sleepiness
Allergies: Lactose, sucralose, bactrim, sulfa drugs, ivp dye
Diagnostic Lab Data: Blood panels, CT scan of throat, Chest xray
CDC Split Type:

Write-up: Time of vaccine: Flushing, feeling faint/dizzy, fast heart beat., feeling hot. Later that day, about 6 hours after vaccine: difficulty swallowing/dyspepsia, unable to swallow food, water without pain, narrowing of throat.


VAERS ID: 1196772 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 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: none
Preexisting Conditions: GERD, dyslipidemia, obesity, low back pain, seasonal allergies, ,gastritis, fatty liver, snoring
Allergies: Allegra 60mg 1 tab once a day, acetaminophen 325mg 2 tabs every 4 hours prn
Diagnostic Lab Data: None done, patient just reported response today
CDC Split Type:

Write-up: Patient had nosebleeds for 2-3 days post vaccination, now subsided


VAERS ID: 1196773 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Depression
SMQs:, Depression (excl suicide and self injury) (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: Multi-vitamin, calcium, super b complex, fish oil, vitamin D, trintellix, valacyclovir, risperidone, Metamucil, propranolol, famotidine, omeprazile, estradiol, montelukast, lyothyronine
Current Illness: Depression, anxiety, migraines, asthma, Herpes
Preexisting Conditions: Depression, anxiety, asthma, Herpes
Allergies: Bactrum
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The day after the injection I was severely depressed the entire day. I was fine the day before and the day after. I happened to have an appointment with my psychiatrist that day and told her about it.


VAERS ID: 1196784 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: School       Purchased by: ?
Symptoms: Erythema, Immediate post-injection reaction, Injection site oedema, Pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Immediate pain, erythema, edema at injection site


VAERS ID: 1196786 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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: many events like this, with previous injections, IV starts, or blood draws
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported prior to vaccination, that it is common for him to become faint and possibly "pass out" when receiving injections, having blood draws completed, and IVs started. Verified that client was feeling well and had eaten breakfast and was hydrated prior to injection. Client sitting in chair and tolerated injection well. About 5 minutes after injection given, client reported that he was feeling faint. Client was clammy and pale, and lost consciousness for about 30 seconds. Wife present and held his head and stood next to him in the chair. Client did not fall, and stayed seated in the chair. He slowly regained consciousness, and when able to sit and speak, client was offered water, which he accepted. VS collected - BP sitting in RUE - 108/78, P - 64, R - 16, O2 sats - 96%. Client started to regain color, and report that he was feeling better. Granola bar offered and client ate. Wife reported that this is a common event for client, when having blood drawn, IVs started, or injections given. Client states that he has "passed out many times before." Client stayed seated in chair, with RN and wife in room with him. By 0945, client states that he was feeling "back to normal." No s/s of allergic reaction. Wife to drive home and stay with husband for the rest of the day. Discussed s/s of allergic reaction, and other s/s that require immediate medical attention. Wife and client verbalized understanding.


VAERS ID: 1196794 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chills, Feeling cold, Injection site pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Urine analysis normal, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: On April 10, 2021 the doctor ordered a covid-19 test which came back negative. I also had a urine analysis done the same day which the results show that everything was in the normal range.
CDC Split Type:

Write-up: At around 6:30 p.m on April 9, 2021, I started to feel very cold at home. I had sever chills where I was under 5 heavy blankets unable to get warm. I also had a high fever which was 104.8 degrees Fahrenheit. I also threw up twice and had body aches in my arm where the nurse injected the vaccine, my lower back, and calves of my legs. When my temperature did not go down, I went to Emergency Room at around 12:00 a.m. April 10, 2021. I was placed in isolation. The nurse took my vitals and the doctor ordered covid test for me and a urine analysis. The covid test came back negative and my urine analysis was in the normal range. The nurse gave me Tynenol at around 1 am and ibuprofen at around 2:30 am. I was discharged at approximately 5 am on April 10, 2021 with a 98.4 degree temperature.


VAERS ID: 1196847 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Hypoaesthesia, Pain, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), 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: 1st does of DPT vaccine at 2 months old (July 1989); Swollen/red arm. The next two doses of vaccine, I was only given the DT (Pe
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within about 12 hours of getting the vaccine, I started having chills, fever and severe body aches. I took extra strength Tylonol and those symptoms subsided within about 48 hours. The symptom that worries me is the tingling in both my arms that seems to get worse when I lay down. Each night since I received the vaccine, my arms have gone completely numb in the middle of the night. Once I move them repeatedly for about 5-10 min, the numbness goes away. Before the numbness starts, my arms usually begin to tingle.


VAERS ID: 1196887 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-01
Onset:2021-04-09
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 AND EL 9 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Localised infection, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot caused tightness in throat.
Other Medications: Cephalexin 500 mg. Herbal tea Ibuprofen
Current Illness: Bad allergy symptoms.
Preexisting Conditions: Frost bite and hypothermia survivor with numerous vascular and nerve issues as well as orthopedic.
Allergies: Phenegren Sulfa Molds Codeine Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started cephalexin for a bad foot infection..had taken it in past with zero issues...within 30 minutes had horrible lung on burning clenched up fire, gasping and coughing for breath, hives all over me reaction.


VAERS ID: 1196890 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Underdose, Wrong technique in product usage process
SMQs:, Medication errors (narrow)

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

Write-up: Patient was injected with an empty sterile/unused needle that had not yet been drawn up with vaccine prior to receiving the actual dose.


VAERS ID: 1196897 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Public       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not available
Current Illness: No
Preexisting Conditions: History of triple bypass, has pacemaker
Allergies: Midol
Diagnostic Lab Data: Not available
CDC Split Type:

Write-up: Received 2 doses of Johnson and Johnson Vaccine on 4/9/21. Patient held in observation for about 1 hour, did not display any reaction at time of departure from clinic.


VAERS ID: 1196901 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Disorientation, Dizziness, Dysarthria, Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: propranolol vitamin D calcium
Current Illness: none known
Preexisting Conditions: cerebral palsy which affected mental not physical
Allergies: bees
Diagnostic Lab Data: blood work 4/9/21 chest xray 4/9/21
CDC Split Type:

Write-up: around 3 AM patient got dizzy and passed out. When I talked to patient at 6:30 AM, he stated to me that he was dizzy and fell during the night, his voice was very slurred and I could hardly understand him, he was also very disoriented. Took him to hospital ER around 7 AM


VAERS ID: 1196909 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site bruising, Pain in extremity, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin XL 150 mg qd Vitamin D 4000 I/u Turmeric 1000 mg B12 1000 mg Probiotic Famotidine 20 mg Pseudoephedrine
Current Illness: None
Preexisting Conditions: Mild asthma Ulcerative proctitis Depression /anxiety
Allergies: Penicillin Cephalosporins
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaginal spotting 24 hours after vaccination , on 4-9-2021 Headache, arm soreness noted 48 hours after vaccination, lasting ~ 24 hours , noted 4-10-2021 Bruise at site of injection noted on 4-12?may have been present prior to this date but went unnoticed


VAERS ID: 1196926 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Feeling abnormal, Headache, Heart rate increased, Hyperacusis, Musculoskeletal stiffness, Nausea, Pain, Palpitations, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Arthritis (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 9 April 11:07am: got the vaccine 12:00: started feeling an underlying headache. 15:00pm: very fatigued, headache increased, slightly nauseous. 16:30pm: started feeling better, but still have an underlying headache. Appetite came back. 17:42pm: started feeling a fever develop. 23:30pm: temp. were normal 97?F. 10 April 03:30am: +102?F fever, body pain, Took one 500mg Tylenol, Stayed awake until 04:17 with elevate heart rate and it felt like my heart was pounding through my chest. Headache increased and I started to experience neck stiffness. 04:17: Temp 98.9?F. 04:39am: took another Tylenol 500mg and finally slept. 10:00am: woke up 11:31am: had breakfast and took Tylenol 500mg. Underlying headache, neck stiffness, light chills, ears are sensitive to sound. Elevated heart rate and increase blood pressure. Could feel my heart beating very strongly and intensely. 16:07pm: fever chills continued to be more severe. Latest temp is 102.2?F. Took another Tylenol 500mg. Heart rate is still elevated and beating very strongly. Headache and neck stiffness. 18:35pm: Temp 102.7 F. Heart, head and neck same as above. 18:42pm: temp 102.3 F. Heart, head and neck same as above. 19:30pm: Went to Urgent Care to seek medical assistance as my condition deteriorated. Received 975mg of Tylenol from Urgent Care unit. 20:00pm: Transferred to Hospital ER facility for further checks/tests. 21:20pm: Temperature gone done from fever levels. Still waiting for doctors to tend to my case. 22:05pm: Doctor came to see me and suggested an IV to hydrate me. 11 April 12:58am: Received the IV and pain medicine. 02:03am: IV completed, headache and neck stiffness reduced. Heart rate still very elevated and pounding strongly. 11:00am: Still had an underlying headache, dizziness and foggy mind.


VAERS ID: 1196998 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Body temperature increased, Chills, Headache, Hypertension, Nasopharyngitis, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 615pm went to sleep, 9pm woke up with headache that was moderate to severe, chills and racing heart later on my blood pressure went up to hypertension levels..my temp was 103.8, the back of my shot arm was ice cold, took 1 ibuprofen, 909pm 102.4 temp took 2nd ibuprofen, BP 155/82 @ 1059pm, 129/78@11pm. Racing heart between 121-111@1058pm. 99% oxygen. 1201pm 2 Tylenol rapid release, 101.2 temp heart racing 108-109, symptoms unchanged, 1232am 142/86, 100.8 temp 99% oxygen Symptoms mild. 122/83, 101-102 heart still racing melatonin taken..100.1 temp, 1:52 am 94-95 , 99.2 temp, 6:24 sleeping 70-71 heart rate 96.1 temp


VAERS ID: 1197011 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Epi-pen 0.3mg/0.3ml for below allergens
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Kale, Ginger, Naproxen
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Assistant checked on Pt at 5min mark after administration and Pt c/o itchy throat and nose with itchy at injection site. Soft rapid was called and Pt was given 50mg/ml diphenhydramine. RN remained with Pt for 15 minutes after IM administration and Pt stated feeling better with non s/sx. follow up with Provider given.


VAERS ID: 1197020 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / -

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

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

Write-up: Significant lower back pain


VAERS ID: 1197029 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

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

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

Write-up: ?Janssen COVID-19 Vaccine EUA? slight headache, cold chills during Thursday night, felt horrible on Friday and vomited entire day on Friday.


VAERS ID: 1197065 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram thorax normal, Dizziness, Echocardiogram normal, Influenza like illness, Scan with contrast, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fish oil caplets, dietary supplements (ginger, turmeric, and Vitamin D).
Current Illness: None.
Preexisting Conditions: None.
Allergies: Crustacean / shell fish.
Diagnostic Lab Data: Over the course of Apr 9 and Apr 10, patient had lab work done on 3 blood draw, had a chest X-ray taken, a brain CT scan, a chest CT scan with contrast, and an echo cardiogram. None showed any signs of injury or pathology.
CDC Split Type:

Write-up: Beyond initial flu-like symptoms, patient initially experienced bouts of light-headedness at around 10:30 a.m. the day after the 2nd shot - which was Apr 9, 2021. After laying down for a couple of hours, the patient tried to have lunch, but experienced syncope at around 12:45 p.m. Patient''s spouse could not revive them initially, so called 9-1-1.


VAERS ID: 1197111 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZIA / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Circulatory collapse, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: bystolic and antianxiety statin
Current Illness:
Preexisting Conditions:
Allergies: pineapple, kiwi and strawberry and rubber
Diagnostic Lab Data:
CDC Split Type:

Write-up: Weakness collapse loss of falling fever


VAERS ID: 1197113 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hypersensitivity, Pharyngeal swelling, Rash, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies: Bee Venom Strawberries Raspberry
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 54 y.o. female who presents with concern for allergic reaction. Patient received her second Covid vaccine today. Shortly after this she felt very faint and almost passed out. She then developed a rash over her chest and felt like had a scratchy throat that was slightly swollen to her. She was given 1 dose of IM epinephrine with significant improvement in symptoms. She states he does have a history of allergy to strawberries as well as bees. Last time she had very she developed hives and vomited. She is feeling significantly better now no significant shortness of breath and her throat feels better. No nausea or vomiting or diarrhea at this time. Patient otherwise fairly healthy with no major medical problems.


VAERS ID: 1197122 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bruxism, Euphoric mood, Feeling cold, Hallucination, Headache, Hyperhidrosis, Injection site bruising, Injection site pain, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Vitamin D, multi-vitamin, fish oil, CBD, elderberry, berberine, andrographis, marshmallow root, echinacea, astragalus, boswellia, turmeric, sceletium tortuosum, chelated boron, reishi mushroom extract, l-glutamine, collagen, sage, holy basi
Current Illness:
Preexisting Conditions: Celiac disease
Allergies: Celiac disease. I also had a very severe reaction to allergy shots I was receiving to treat several venom (bee, wasp, hornet, etc.) allergies when I was in middle school (around 12 years old)
Diagnostic Lab Data:
CDC Split Type:

Write-up: My initial symptoms were light swelling a region around the shoulder of my injection arm and excessive sweating in the armpit on my injection arm side. Following this, symptoms similar to being on a hallucinogenic gradually manifested over the next several hours, including euphoria, a persistent urge to grind teeth, and some mild-to-moderate visual and physical effects. Following the date of the injection, the primary symptom has been a bruise/cramp hybrid pain in the upper arm of the injection site that is gradually receding (but still ongoing), along with random light bouts of nausea and headaches, random light pains throughout my injection arm, and occurrences of coldness in my injection arm (lasts about an hour)


VAERS ID: 1197133 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A-21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac function test, Chills, Dyspnoea, Electrocardiogram, Electrocardiogram ambulatory, Fatigue, Feeling abnormal, Fibrin D dimer, Full blood count, Metabolic function test, Pain, Palpitations, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: EKG, Holter monitor, CBC, Chem Profile, Cardiac Profile, D-dimer, bag of fluids given and 1 bag of Magnesium sulfate given all done during ER visit 4/9/2021 @ 2200. Will be following up with cardiologist later this week.
CDC Split Type:

Write-up: At 1500 started having chills, running a fever and was very shaky. Took Tylenol and rested. Around 2100 woke up feeling even worse and felt like heart was racing with frequent pauses (3-5 PVC''s/minute). Following ER visit continued to feel tired, achy, and occasional SOB.


VAERS ID: 1197134 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Muscle spasms, Myalgia, Nausea, Pain, Pruritus, Pyrexia, Rash, Rhinorrhoea, Sneezing, Tremor, Vaccination site mass, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: ibuprohen, acetaminophen
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Rash in the neck, upper back and arm. Body Itchy sensation, nausea, headaches, high fever 101-100-102, body ache, muscle pain, sneezing a lot, vomit, bump in the left arm where the vaccine was placed, feeling overtired, chills, and body shaking, leg muscle spasms, runny nose. I have been feeling all of the above since Friday 4/09/21. As of today (4/12/21) at 12 pm the fever is between 99-100 which is getting lower however, I still have the above reaction.


VAERS ID: 1197143 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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: Claratin
Current Illness:
Preexisting Conditions: Seasonal allergies
Allergies: Minor gluten/lactose intolerance
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Approximately 8 hours after vaccine, states getting chills, followed by a fever of 102.6 degrees F that lasted over night and a lower fever between 100/101 degrees f the follow day. Felt exhausted and muscle aches and dizzy. By Sunday was just tired with no fever. And felt almost 100% by Sunday evening (58 hours after vaccine).


VAERS ID: 1197150 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia, Neck pain, 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: Shingrix
Other Medications: prasugrel, aspirin, Bystolic, armour thyroid, montelukast, vitacirc, insulin
Current Illness: Type 1 diabetes, asthma, hypothyroid, CAD, hypertension
Preexisting Conditions: Type 1 diabetes, asthma, hypothyroid
Allergies: lisinopril, benecar, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Myalgia, headache, neck ache, fever, fatigue


VAERS ID: 1197158 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Dizziness, Fatigue, Feeling cold, Headache, Myalgia, Pain, Pyrexia, Skin burning sensation
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Iron, Thyroid and Prozac
Current Illness: None
Preexisting Conditions: PCOS, Hypothyroid, Insulin resistance and low iron.
Allergies: Septra
Diagnostic Lab Data: I didn''t go to the doctor or the hospital for the side effects. My family thought I should have, but I honestly felt so bad I didn''t want to get out of bed.
CDC Split Type:

Write-up: Dizzy, lightheaded, headache, chills, muscle and joint pain, weakness, extremely tired. Well I laid in the bed with two blankets and took tylenol. Once I was done freezing and with the fever it felt like my skin was on fire. I was in so much pain that night that I couldn''t move without crying. After I slept that night and about 7 hours the next day I finally started to feel better.


VAERS ID: 1197264 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Headache, Pain, Rhinorrhoea, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (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: probiotic, lexapro,protonix,ambien,zertec
Current Illness: none
Preexisting Conditions: reflux
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: chills,skin burning sensation, body aches,headache,cough, runny nose tiredness for 3 days, Tylenol and bed rest.


VAERS ID: 1197303 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 021A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chest pain, Dyspnoea, Hypertension, Hypoaesthesia, Pain, Pyrexia, Trismus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called the pharmacy on Monday, 4/12 to report an adverse reaction through the night on Friday, April 9 into Saturday, April 10. Patient reported had been taking ibuprofen following administration of Janssen vaccine on Friday at 9 AM. On Friday evening, patient reported that body temperature began to rise, going as high as 102.5 degrees F. Patient reported going to bed, then awakening early Saturday morning with a feeling of shortness of breath, intense pain in his left side that he described as "knives" in his chest, numbness in hands and legs, as well as body aches. He stated his jaw was locked up and he had bit his tongue. Patient''s father called 9-1-1, paramedics arrived and were able to stabilize the patient at home. Patient stated his BP was elevated, however HR and 02 saturation was within normal limits. Patient reported to pharmacy on Monday, 4/12 and stated symptoms have resolved other than mild fever.


VAERS ID: 1197308 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Syncopal episiode


VAERS ID: 1197364 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt complained of SOB the next day and was admitted to hospital and discharged the next day


VAERS ID: 1197385 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

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

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

Write-up: Fever of 99 to 101, chills, body aches, headache, fatigue, soreness at injection site.


VAERS ID: 1197693 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A LA / IM

Administered by: School       Purchased by: ?
Symptoms: Asthenia, Hypoaesthesia, Limb discomfort, Mobility decreased, Neuralgia, Pain
SMQs:, Peripheral neuropathy (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (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: Welbutrin and Paxil, but neither were taken the day of vaccination
Current Illness: None
Preexisting Conditions: None
Allergies: Mold
Diagnostic Lab Data:
CDC Split Type:

Write-up: Around 6pm I started having normal mild reactions to the covid vaccine. Around 10pm I lost feeling in both arms and my lower legs, but otherwise was still able to move without pain. At about 10:30, the loss of feeling turned into partial paralysis and extreme pain where feeling had been previously lost. My hands refused to stay in any position except for a clenched fist or fingers completely extended. Moving my arms and lower legs was only able to be done with great difficulty. I was worried that it would spread to my chest, so I got up from where I''d been sitting at a desk and began forcing myself to walk up and down my apartment hallway. I was able to do this though my gait was stuttery and uneven, and my pain was about an 8 out of 10. I was alone in my apartment at the time and my hands weren''t working well enough to handle my phone. After about 10 or 15 minutes the nerve pain and paralysis subsided and hasn''t come back since, but my leg muscles felt incredibly weak the rest of the night and my partner had to help me to make sure I didn''t fall over a couple of times. I didn''t end up going to the doctor or seeking treatment because it didn''t come back.


VAERS ID: 1197707 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site pruritus, Injection site reaction, Injection site warmth, 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: No
Current Illness: Multiple sclerosis, and hyperthyroidism
Preexisting Conditions: Multiple sclerosis and hyperthyroidism.
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient received the Janssen vaccine on Thurs. 04/08/21. Friday, 04/09/21 the patient work up and has a big red welt at the injection site. The welt is hot to touch and itchy. The patient was instructed to take benedryl PO.


VAERS ID: 1197770 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: NONE
Preexisting Conditions:
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: TONGUE SWELLING ON RETURN TRIP HOME. PATIENT TOOK BENADRYL.


VAERS ID: 1197794 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: NONE
Preexisting Conditions:
Allergies: NON
Diagnostic Lab Data:
CDC Split Type:

Write-up: TONGUE SWELLING ON RETURN TRIP HOME - PATIENT TOOK BENADRYL


VAERS ID: 1197801 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Chest pain, Chills, Echocardiogram normal, Electrocardiogram ST segment elevation, Hyperhidrosis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness:
Preexisting Conditions: Hashimoto''s thyroiditis
Allergies: none
Diagnostic Lab Data: He was found to have EKG changes of diffuse ST elevations and troponin elevation with a peak of 20. CK-MB also elevated. ECHO showed normal EF. After 24 hours troponin levels started coming down and chest pain resolved
CDC Split Type:

Write-up: Patient began having chills, fevers and sweats within 12 hours of receiving the vaccine. 2 days later he had severe chest pain prompting him to present to the hospital.


VAERS ID: 1197842 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Dizziness, Nausea, Neck pain, Pain, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: pt says she started having pain in her right arm, neck, shoulder pain, and her back. Her entire body ached and she became lightheaded and dizzy. Pt says the right arm is still swollen and sore and she also has slight nausea, lightheaded and dizziness.


VAERS ID: 1197882 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: Ibs-d, activity induced asthma
Allergies: Na
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, body ache, fever, brain fog


VAERS ID: 1197883 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Dysstasia, Feeling abnormal, Nausea, Vertigo positional, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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: Chlorthalidone, lisinopril, rosuvastatin, amlodipine, vitamin D3,
Current Illness:
Preexisting Conditions: Hypertension, hypertensive cardiovascular disease, cataracts
Allergies: None to food or medications. Have had contact type allergy to non-precious metal used in inexpensive jewelry.
Diagnostic Lab Data: None. Did not. contact doctor.
CDC Split Type:

Write-up: Awoke 3rd day after vaccination with severe positional vertigo or similar disorder - felt when I simply turned my head on pillow. It was as if I was falling in space, especially my head. Could not sit up without feeling terrible. Lessened somewhat during day but could not move head without feeling vertigo/dizziness. Unable to eat without nausea and vomiting. That was 04/09/21. On 04/10 and 04/11 it was difficult to arise from bed without feeling very dizzy. But after getting up very slowly without moving head, I could move slowly to use bathroom, get a little food, etc. Today, 04/12, still had to arise from bed very slowly, trying not to move head to avoid weird dizzy type feeling. Have been able to eat, get dressed and leave the house carefully. Try not to move head too much and move rather slowly.


VAERS ID: 1197924 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Loss of personal independence in daily activities, Sleep disorder, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Flovent HFA, Vitamin C, Zinc, Magnesium, Vitamin D, NAC, Probiotic
Current Illness: None
Preexisting Conditions: Tinnitus started in 2013 but well managed since 2014 with minimal flare ups. Anxiety - treated with Zoloft.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe Tinnitus flare up and dizziness started approximately 12 hours after vaccine administered. No tinnitus or dizziness in prior two weeks before receipt of the vaccine on April 8th at 2:00 pm. Dizziness resolved after about 72 hours. Tinnitus still present 24 hours a day, every day. Moderately disruptive to sleep and ability to function.


VAERS ID: 1197962 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-01
Onset:2021-04-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Cartilage injury, Injection site pain, Joint instability, Pain, Physical examination of joints abnormal
SMQs:, Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: X-ray ordered. Referred to orthopedic specialist
CDC Split Type:

Write-up: 29yo man who is an active swimmer presenting with persistent significant left shoulder pain, worse with activity. Coincides with getting his first covid vaccine 5-7 days earlier. Occurred the evening after his first swim after the covid vaccine. Exam notable for significant pain and shoulder instability. Worse pain was with external rotation. No evidence of impingement. test positive. Empty can test somewhat positive. Concern for labral vs rotator cuff issues. Referred to Ortho for second opinion. x-ray ordered and will follow up with MRI.


VAERS ID: 1197965 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Muscle rigidity
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 (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: HUSBAND CALLED 911. SHE WAS TAKEN TO MEDICAL CENTER TO BE CHECKED OUT. SHE SAID SHE FELT FINE AFTER BEING RELEASED. SHE SAID MEDICAL PERSONNEL THOUGHT IT WAS RELATED TO THE VACCINATION. SHE CALLED AND REPORTED TO ME 4/10/21. SHE STATED THAT SHE STILL FELT OK.
CDC Split Type:

Write-up: PASSED OUT, WENT RIGID TEMPORARILY


VAERS ID: 1197967 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Rash with hives on both arms and legs....parts of neck and top of shoulders. Dr prescribed Prednisone, Cetirizine, and Cimetidine


VAERS ID: 1197975 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Influenza A virus test negative, Influenza B virus test, SARS-CoV-2 test negative
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec, Asmanex, Singular, Allegra, Flonase, multi-vitamin, vitamin D, magnesium
Current Illness: Ischemic colitis
Preexisting Conditions: Asthma
Allergies: Wheat, soy, dairy, latex.
Diagnostic Lab Data: COVID and Flu A&B tests on 4/12/2021, both came back negative.
CDC Split Type:

Write-up: I lost my sense of taste and smell on 4/11/2021 and have not regained either to date.


VAERS ID: 1197994 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Fatigue, Flushing, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Janssen COVID-19 Vaccine EUA Passed out while seated, 3-4 minutes after receiving vaccine. Fast onset of extreme nausea followed by blackout. Duration of blackout unknown. Woke up on floor not knowing how I got there. Sat up, nausea and lightheadedness returned, then dissipated with no further blackout. Felt rush of blood from head to toe and felt okay after that. Pharmacy staff took blood pressure, readings were close to normal (slightly elevated). Paramedics were called by pharmacy, and their BP readings were also close to normal. After all that, aside from some fatigue, no other appreciable side effects over the next 48 hours. No nausea, flu-like symptoms or fever, and very little soreness at injection site.


VAERS ID: 1198033 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, 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: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: lightheadedness within 5 minutes of vaccination vomiting within 7 minutes of vaccination


VAERS ID: 1198089 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenopia, Back pain, Chest discomfort, Chills, Crying, Decreased appetite, Discomfort, Dysarthria, Erythema, Fatigue, Feeling abnormal, Feeling cold, Feeling hot, Gait disturbance, Headache, Hyperhidrosis, Hypokinesia, Injection site pain, Myalgia, Nausea, Pain, Pain in extremity, Rash macular, Tinnitus, Tongue pruritus, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (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: Xanax, isotretinoin, DIM
Current Illness:
Preexisting Conditions: MVP, MDD, clinical anxiety, GERD, low blood pressure
Allergies: Nothing I know of
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine at 12:50 20 minutes after shot: fuzzy, drugged 35 minutes after: face and neck was red and blotchy and itchy. Tongue was itchy. Pain at injection site Drive home was bad. Slurring my words. Eyes were so heavy, hard to keep open. I felt weight on me. Pressure on my chest, heart was tight. Fatigue. Started hysterically crying. Got home, couldn?t walk normally. Sweating. Chills started at 8 Body aches at 9 Woke up with TERRIBLE body aches at 11:40. Skin was so hot, I was shivering cold. My legs hurt so bad. My knees mostly. My ankles. My inner thigh muscles. My lower back couldn?t handle any pressure. It hurt to lay. My left shoulder blade and upper arm hurt bad. Then my head hurt. My hips couldn?t move. My elbow felt weak and painful, like they would break. 12:40 headache got worse. I was shaking. I was nauseous. Chills were awful. Ears were ringing. No appetite for days. Sore joints, muscle pain and fatigue still 4/13


VAERS ID: 1198096 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Eye pruritus, Eyelid oedema, Lacrimation increased
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Itchy, watery eyes, followed by significant edema in eyelids. Took over-the-counter Benadryl (50 mg) 2-3 times per day to manage symptoms. Symptoms still present 3 days later, but much less intense.


VAERS ID: 1198112 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Headache, radiating pain in lower back upwards towards shoulder blades and downwards into legs. Over all tiredness/fatigue and aches.


VAERS ID: 1198184 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: recent surgery (unknown reason/type of surgery or date of surgery) reported by patient''s brother
Preexisting Conditions: asthma (treated with albuterol when needed, but not recently)
Allergies: allergy to penicillin
Diagnostic Lab Data: None at this facility (unsure if any tests were done at the emergency department where patient was transferred)
CDC Split Type:

Write-up: After being screened to enter the healthcare facility and completing the intake screening for COVID vaccine, patient received the Janssen COVID vaccine at approximately 11:00am. Several minutes later while sitting in the observation area, patient stated that he felt like throwing up and that he had a headache. He said he just started feeling tired. He denied any shortness of breath, swelling in his mouth or throat, or rashes. He stated he had not eaten breakfast in the morning. When his vital signs were checked, his blood pressure was 149/94 and heart rate was 90. He was alert and oriented. He was transported to the facility urgent care for further assessment and observation. In urgent care, he appeared to become more lethargic, although his vital signs remained stable. 911 was called. While waiting for the ambulance, staff spoke to the patient''s brother (who had been waiting outside for patient). Patient''s brother stated that patient had a fever and stomachache the night before, and that patient had a recent surgery and had not completed his post-op antibiotic course. Patient''s brother stated that he came to clinic anyways for the vaccine appointment because he wanted to get the COVID vaccine so that he could return to work (as required by his employer). Patient was transported to Hospital. Per nurse report, he was released from the emergency room after a brief observation period.


VAERS ID: 1198188 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Shortness of breath and dizziness within one hour, headache and fever within 24 hours, continuing head ache and body aches into 3rd day following.


VAERS ID: 1198224 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Influenza like illness, Injection site erythema, Muscle fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Mild pain and redness at injection site. General wide-spread muscle soreness and fatigue after 12 hours and continuing into second and third day. Symptoms consistent with very mild flu vaccine reaction or very mild case of flu. Symptoms lessening on third day after vaccine with some continued muscle fatigue, particularly after activity.


VAERS ID: 1198226 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Cold sweat, Dyspnoea, Hyperhidrosis, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient received her vaccine and was being observed in the observation area upon becoming diaphoretic, pale, clammy and not looking well. RN approached asked if she was having difficulty breathing and pt reported yes. initially unable to obtain pulse or 02 reading. BP 58/38 and Epi injection was administered to the right outer thigh. Patient color and vitals started to improve and breathing was better. patient also was placed on cot in supine position initially. Last set of vitals prior to EMS arriving was BP 84/72, p-71, 02-99% and respirations are 22.


VAERS ID: 1198260 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Feeling of body temperature change, Headache, Hyperhidrosis, Migraine, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Headache and migraines Mortan Joint pain matron Nausea Hot cold sweats


VAERS ID: 1198386 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Chills, Fatigue, Headache, Insomnia, Nausea
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: chills, very nauseous, couldn''t sleep, terrible head aches followed by bad stomach pains. All of this for 24 hours. Then more stomach pains couldn''t eat because of nausea for another 24 hours. Very tired and weak. Each day gets a little better


VAERS ID: 1198403 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Loss of consciousness, Panic attack
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: Patient has passed out before. Likely a panic attack.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient passed out. Mother stated he gets panic attacks every time he has a needle stick. Patient was fine shortly after.


VAERS ID: 1198426 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Feeling abnormal, Injection site bruising, Injection site macule, Injection site pain, Injection site swelling, Injection site warmth, Pain, Skin mass
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rampiril, hydrochlorothiazide, cytomel, dyclophen,
Current Illness: arthritis, carpal tunnel, hashimoto''s disease
Preexisting Conditions: Hashimoto''s Disease
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient reported an extreme burning sensation at time of injection. She described it as like "lightening", both electrical and heat that radiated from the injection site to her fingertips. Pain started with administration of vaccine. She felt "crumby" on Saturday. Today she no longer feels the burning sensation, but has a 1/2" ring around injection site that is swollen and bruised. She also reported feeling a knot under her skin. She did not seek medical attention and was quite embarrassed that she cried after her injection.


VAERS ID: 1198445 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-30
Onset:2021-04-09
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute pulmonary oedema, Acute respiratory failure, Anaphylactic reaction, Angiogram pulmonary abnormal, Bilevel positive airway pressure, COVID-19, COVID-19 pneumonia, Cardiomegaly, Condition aggravated, Dyspnoea, Hepatic steatosis, Hypersensitivity, Lung opacity, SARS-CoV-2 test positive, Wheezing
SMQs:, Cardiac failure (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ascorbic acid-multivit-min-MSM 1,000-1,000 mg pwep aspirin 81 mg tablet atenoloL (TENORMIN) 25 mg tablet blood sugar diagnostic (BLOOD GLUCOSE TEST) strip blood sugar diagnostic (BLOOD GLUCOSE TEST) strip Blood-Glucose Meter (ACCU-CHEK GUID
Current Illness: Ear pain, Sinus pain, cough, sinus drainage on 3/4/21
Preexisting Conditions: Obesity, unspecified Depressive disorder, not elsewhere classified Paroxysmal supraventricular tachycardia (HC) Unspecified sinusitis (chronic) Influenza with other respiratory manifestations Balanoposthitis Impotence of organic origin Contact dermatitis and other eczema due to plants (except food) Primary localized osteoarthrosis, lower leg Other disorders of synovium, tendon, and bursa(727.89) Palpitations Family history of other digestive disorders Knee joint replacement by other means TIA (transient ischemic attack) Encounter for screening colonoscopy Dysphagia Retinal detachment Diabetic eye exam (HC) SVT (supraventricular tachycardia) (HC) Atrial fibrillation (HC)
Allergies: Statins-hmg-coa Reductase Inhibitors Vicodin [Hydrocodone-acetaminophen] Morphine Doxycycline
Diagnostic Lab Data: INDICATION: PE suspected, high pretest prob, Covid positive. Hypoxic. COMPARISON: CT abdomen and pelvis from 12/30/2017. TECHNIQUE: CT chest pulmonary angiogram during arterial phase injection of IV contrast. Multiplanar reformats and MIP reconstructions were performed. Dose reduction techniques were used. CONTRAST: IOHEXOL 350 MG IODINE/ML IV 75 ML: 75mL FINDINGS: ANGIOGRAM CHEST: No pulmonary artery filling defects. The aorta is normal in caliber. LUNGS AND PLEURA: Patchy groundglass and consolidative opacities. There are interspersed areas of interlobular septal thickening within these groundglass opacities compatible with a "crazy paving" pattern. No effusions or pneumothorax. Similar 3 mm micronodule in the right middle lobe dating back to at least 2017 and statistically benign. Otherwise, no convincing new pulmonary nodules. MEDIASTINUM/AXILLAE: Mild cardiomegaly. Enlarged left AP window lymph node measuring 1.3 x 1.3 cm (series 4/54). No enlarged right hilar lymph node measures 2.1 x 2.2 cm (series 4/71). CORONARY ARTERY CALCIFICATION: Moderate. UPPER ABDOMEN: Hepatic steatosis. Scattered hepatic hypodensities percent characterized as cysts are seen on series 4 image 106, 154, and 164. Partially visualized simple or benign left renal cyst is again seen. No dedicated follow-up is required. MUSCULOSKELETAL: Degenerative changes of the spine. IMPRESSION: 1. No pulmonary embolus. 2. COVID pneumonia. There may be a component of superimposed pulmonary edema. 3. A few mildly enlarged mediastinal lymph nodes are favored to be reactive. 4. Mild cardiomegaly. 5. Hepatic steatosis.
CDC Split Type:

Write-up: He tested positive for COVID-19 on April 7 2021. He qualified for monoclonal antibody therapy and presented for that therapy 4/9/2021. After starting the infusion he developed sudden onset shortness of breath. He is noted to be wheezing. He was given Solu-Medrol and benadryl prior to transfer to ED. Acute hypoxic respiratory failure in patient with recent Covid diagnosis with sudden worsening during monoclonal antibody infusion. Differential includes allergic reaction/anaphylaxis, flash pulmonary edema, worsening Covid. Given the wheezing he was given a DuoNeb with no significant improvement but may be slightly decreased wheezing. Patient was placed on BiPAP given concern for pulmonary edema and increased work of breathing. We were able to titrate down the FiO2 to 40%. He was transitioned to high flow nasal cannula. Will admit to the hospital for further supportive cares given Covid and hypoxic respiratory failure.


VAERS ID: 1198461 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Burning sensation, Dizziness, Fatigue, Migraine, Neck mass, Pyrexia, Sensation of foreign body, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I got the vaccine Tuesday evening and felt fine until Wednesday morning when I got a migraine and a fever. Thursday I felt mostly fine just some tiredness and a little weakness. Friday evening I started to feel light headed and then by Friday night I felt a lump in my throat and my neck felt like it was burning. The burning continued into Saturday. I went to the pharmacist and he told me to take some Tylenol and an antihistamine. That helped a lot with the burning feeling. Sunday I felt very weak all day and felt more of a slight tightness in my throat. Monday the weakness and tightness in the throat continued just not as extreme.


VAERS ID: 1198466 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

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

Write-up: gave johnson and johnson covid 19 vaccine to 17year old age is 18


VAERS ID: 1198509 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood potassium decreased, Chest X-ray normal, Chest pain, Full blood count normal, Pharyngeal swelling, Swollen tongue, Tachycardia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Bee stings
Diagnostic Lab Data: CDC done and chest xray - all normal except for low potassium.
CDC Split Type: 00324

Write-up: C/O tongue and throat swelling, chest pain 15 minutes after injection; tachy, BP 132/84; Hx of anaphylactic reaction to bee stings. Carries own epi. Epi and Benadryl given at 30 minutes after injection. 911 called when pt. reported no change in s/s. Was seen in ER and tx with solumedrol.


VAERS ID: 1198511 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042192119 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Hypoaesthesia, Musculoskeletal stiffness, Pain in extremity, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament 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: Ibuprofen Dramamine
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started with shaking body then began pain in waist, toe and ankle joints, knuckles/fingers wrists. Then hands because numb as I started to lay in bed. Then numbness in feet, toes, hands, face, nose, chest and severe stiffness to the point I could not move.


VAERS ID: 1198522 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Asthenia, Asthma, Cough, Dyspnoea, Headache, Oropharyngeal pain, Pharyngeal swelling, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amour Thyroid 2 tablets (60 mg), Liothyrion ( thryroid), 10 mg northodoine, singular 10 mg, Advair 2 puffs am, Abuteral inhaler 2 puffs when experiencing asthma symptoms.
Current Illness: I was not Sick prior to having vaccine.
Preexisting Conditions: Being Treated for following chronic illness: Hashimotos Autoimmune disease, Hypoglycemic, Endometriosis, asthma and allergies.
Allergies: Lactose intolerance Erythromycin, Amoxicillin, generic Azthromycin, Dilutted First ever vaccine had allergic reaction
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 minutes after shot administered in left arm upper bicep. Anaphylactic Reaction: sore throat went to very sore strep throat feeling, throat felt like closing, difficult breathing 15 minutes: coughing asthma began. Blood sugar felt it was dropping ( 20 min prior had breakfast sandwich before shot). Right arm hand tremors began, week in legs even when sitting sever headache. Asked staff get a Benadryl- call 911. Took 25 mg tab benedryl 5 min prior to EMT arrived. Same time another woman started difficulty breathing and staff at facility asked if Emt could look at her too. Emt called another ambulance to scene as strap into gurney. Way to ER gave me liquid steroid. ER given epi, nebulizer breathing treatment Abuterol help breathing, pepicid too. Discharge after 3:30 pm. 40 mg prednisone ( 2 tabs a day for 4 days) and instructed Benedryl 4-6 hours. Use epi pen if throat and sever sore throat comes back- return to er.


VAERS ID: 1198582 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-03-23
Onset:2021-04-09
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Hemiparesis, Ischaemic stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Isosorbide mononitrate 30 mg po daily Toprol XL 25 mg po daily Lipitor 80 mg po daily Aspirin 81 mg po daily
Current Illness: unknown
Preexisting Conditions: CAD Stable angina Dementia
Allergies: NKMA
Diagnostic Lab Data: CT 4/9 - no hemorrhage but no evidence of ischemic stroke CT 4/10 - now evidence of acute ischemic stroke seen Cholesterol levels controlled No other significant lab or test results
CDC Split Type:

Write-up: Patient presented to the ER with right sided extremity weakness. Initial CT showed no hemorrhagic stroke so patient was admitted for treatment of ischemic stroke. Was started on IV Heparin drip and condition improved greatly. Subsequent CT showed small ischemic stroke on left. Patient recovered and was sent home on Plavix, Aspirin and Atorvastatin.


VAERS ID: 1198648 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: At 2:00 pm, the patient had fainted 2-3 minutes after receiving the Janssen covid 19 vaccination. She regained consciousness about 1 minute later. The patient was sitting down, and collapsed over and hit her head on the table. The patient had answered "no" on the VARs consent form that she didn''t have a history of dizziness or fainting after vaccinations. She also verbally answered "no" as well when she was asked if she had a history of dizziness/fainting. It was only AFTER the patient had received the vaccination and fainted that her mother mentioned that her daughter "often faints or gets lightheaded" after receiving vaccinations.


VAERS ID: 1198664 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J&J 202A21A / N/A LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Burning sensation, Chills, Fatigue, Feeling cold, Feeling hot, Headache, Nausea, Pain, Pain of skin, Skin warm
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprintec Claritin Centrum Women
Current Illness: None (COVID - 2 months prior)
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the J&J one-dose vaccine on Thursday, April 8, at approx. 1600. Within an hour I had a mild headache and was nauseous. I went to sleep around 2130. At 0030 (or 30 minutes past midnight) I was awoken to the sudden shock of feeling very cold. My temperature was 91, within 15 minutes I spiked to 100 degrees, and then 15 minutes later I was at 102. I was shivering but felt like I was on fire. I had intense pain throughout my entire body. Internally and topically (skin) my entire body felt like it was on fire -- a burning sensation. Clothes -- even a soft hoodie -- felt like a steel wool scrubber was brushing against my skin and my skin was very hot to touch. I continued to feel nauseous. After 90 minutes of this, I was able to take acetaminophen (2 x 500 mg). After another 90 minutes, my temperature dipped to 99 and the horrible pain mostly subsided. From 0530 to 1830, in three-hour increments, my temperature continued to spike and fall between 99-101 degrees and the pain came in the same waves. Nausea continued. So, I continued an acetaminophen regimen throughout the day to help with the symptoms and took a few tums to help too. After 1830, I felt very weak and tired. My temperature stabilized at normal. Nausea continued. On Saturday, April 10, I was mostly just tired and had minor body aches/soreness. My shoulder bruised where I was vaccinated. Food did not sit well and my stomach was quick to turn. Sunday, April 11, mostly back to normal. Although, still fatigued. No major side effects or symptoms. Monday, April 12, seems to be the same as Sunday. Note: I had COVID the first week of February 2021.


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