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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 97 out of 1,889

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VAERS ID: 1201782 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Dizziness, Dyspnoea, Fatigue, Headache, Injection site erythema, Injection site inflammation, Injection site warmth, Nausea, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? 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: Within 24 hours of vaccine, patient felt nausea, dizziness. Severe fatigue and body aches, 102 degree F fever and headache x 3 days. Shortness of breath x 1 day. Redness, inflammation, heat at area of vaccination and "red line" x 5 days. Instructed patient to apply cold compress and take NSAID. Patient believes she was positive for COVID last fall.


VAERS ID: 1201796 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Feeling cold, Hyperhidrosis, Oxygen saturation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient fainted while sitting in chair. Started sweating profusely, felt clammy and cold. Elevated legs, checked pulse and pulse oximeter. Was awake and talking within a couple minutes. Gave him cold water and crackers and he was feeling much better. Paramedics arrived and confirmed all was good.


VAERS ID: 1201814 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Headache
SMQs:, Neuroleptic malignant 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: NA
Preexisting Conditions: NA
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: HIGH FEVER$g105, HEADACHE


VAERS ID: 1201820 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache, Myalgia, Nausea, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram, Lessina birth control, multi-vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely high fever, light-headed, fainting, muscle aches, chills, nausea. Symptoms began at about 4 pm. By 8 pm, they were unbearable and fainting began. Fever broke at 11:30 pm after laying under cold towels and taking aspirin at 8 pm. Headache and fatigue lasted until noon Saturday (April 10)


VAERS ID: 1201823 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Chills, Fatigue, Headache, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: Zoloft 50mg/day Prenatal Vitamin D K2
Current Illness: no
Preexisting Conditions: psorasis
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever, chills, extreme aches, abdominal pain, severe headache, fatigue all for about 36 hours


VAERS ID: 1201830 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Palpitations, Paraesthesia, Skin discolouration, Skin warm, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: In the span of about 40 minutes following the shot, I had severe reactions. I initially felt really warm in my arm and my heart started to race for a bit. That subsided pretty quickly. Then I got really dizzy, lightheaded and warm and sweaty while waiting the 15 minutes. Then my vision started to blur and I felt tingly in both of my hands and both of my legs. According to others with me, I also went grey. I was given a cool cloth and fanned which helped with a lot of the issues. I also had my legs elevated and was given some slightly sugary food and drink to help the vaccine disperse better. Paramadics and amabulance arrived to assess me. I was improving by the time they arrived and was deemed stable, so I did not go to the hospital for this incident


VAERS ID: 1201852 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: 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: Levothyroxine, iron, vitamin D, B12
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea beginning at 830pm, slight body aches and slight headache. Increasing fever to 101 degrees, which lasted a few hours and broke at 3am. Second day felt mostly fine except for continued body aches which ended around 3pm


VAERS ID: 1201866 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Gait disturbance, Hypoaesthesia, Induration, Malaise, Mass, Menstruation irregular, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: About 9 hours after receiving the Janssen vaccine on April 9th, I started feeling ill. I had a fever of 102, difficulty walking/moving on my own, intense nausea, numbness in my left arm for about 2 minutes, and I spontaneously got my period (which was very regular up until then). I took Tylenol, went to bed, woke up with a 100 degree fever but feeling much better, and it soon dropped back to 98 degrees. Today, on April 13th, I started having pain in my left arm and leg. Specifically, in my left bicep (not the injection site) and my left thigh. This pain does not feel like muscle soreness, but almost like a knot? I''m not sure how to describe it, but I find it odd the pain in my arm increases a bit when I walk/move.


VAERS ID: 1201870 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Nausea Vomiting, Dizziness Sever headache, Server sweating so much she had to change her cloths multiple times and left wet marks on chairs, had to change sheets.


VAERS ID: 1201895 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Movement disorder, Paralysis
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Acetaminophen, Aspirin, Multivitamin, Fluoxetine, Flonase, Levothyroxine, Metoprolol, Pantoprazole, Rosuvastatin, and Trazodone.
Current Illness:
Preexisting Conditions: Hypertension, Atrial Fibrillation, fatigue chronic, hypothyroidism, Mild cognitive impairment, Mitral valve disorder, Insomnia, Urinary incontinence
Allergies: Epinephrine and mint
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states that on the night of 4/9/2021 around 10PM she was laying down and felt paralyzed and could not move for 6 hours. Patient states that she was unable to call 911 because she could not move.


VAERS ID: 1201896 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral normal, Arteriogram carotid normal, Chest pain, Computerised tomogram head normal, Computerised tomogram neck, Electrocardiogram normal, Fibrin D dimer normal, Headache, Hemiparesis, Hypoaesthesia, Immediate post-injection reaction, Limb discomfort, Mobility decreased, Muscular weakness, Neurological symptom, Paraesthesia, Sensory loss, Troponin normal, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypersensitivity (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: PENICILLINS - ANGIOEDEMA
Diagnostic Lab Data: CT head - 4/9/21 - unremarkable CTA head and neck - 4/9/21 - unremarkable EKG - negative D-dimer - WNL Tropnonin - neg
CDC Split Type:

Write-up: This is a 30-year-old female with no significant past medical history who presents to RMC ED with complaints of acute onset headache and left-sided weakness shortly after receiving her first Pfizer COVID-19 vaccine today. Patient states that after the injection she immediately had a headache and several minutes later she developed left-sided numbness tingling and subsequent weakness. She was activated as a code stroke. CT head, CTA head and neck were unremarkable. Patient was evaluated neurology was thought that her symptoms are likely related to vaccine reaction as opposed to acute CVA she is not given TPA. Upon my assessment patient states that she continues to have left-sided weakness both her arm and her leg. She has decreased sensation on her left side. She is able to move her left extremities however she states that they feel heavy and weak. Patient was given Benadryl IV as well as famotidine in the ED. She will be given Solu-Medrol as well. Patient denies any history of any vaccine reactions in the past, to penicillin and seasonal allergies otherwise denies any sensitivities. Denies any history of autoimmune diseases. Patient denies any HA, dizziness, vision changes, chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea, fevers chills, dysuria. This is a 30-year-old female with no significant past medical history who presents to RMC ED with complaints of acute onset headache and left-sided weakness shortly after receiving her first Pfizer COVID-19 vaccine 4/9/21. Patient states that after the injection she immediately had a headache and several minutes later she developed left-sided numbness tingling and subsequent weakness. She was activated as a code stroke. CT head, CTA head and neck were unremarkable. Patient was evaluated neurology was thought that her symptoms are likely related to vaccine reaction as opposed to acute CVA she is not given TPA. Admitting physician felt she has decreased sensation on her left side. She is able to move her left extremities however she states that they feel heavy and weak. Patient was given Benadryl IV as well as famotidine in the ED. She will be given Solu-Medrol as well. Patient denies any history of any vaccine reactions in the past, to penicillin and seasonal allergies otherwise denies any sensitivities. Denies any history of autoimmune diseases. Pt has improved. She is able to move her LUE and LLE now. " Does not feel like moving bricks " Her tingling has decreased and she is able to feel things again with her left hand and leg. Pt had c/o chest pain 4/11/21. Her trop have been neg. EKG neg. D-dimer within normal limits. Will give dose of mobic 7.5 mg. Will try lidoderm patches for pain. Pt will follow up with pcp in 1-2 weeks.


VAERS ID: 1201898 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient complaint on Monday 04/12/2021 of swelling on arm, redness, and swollen.


VAERS ID: 1201901 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever, aches, chills after Flu vaccine twice in last 20 years. Receive flu shot annually.
Other Medications: Men''s chewable vitamin, omeprazole 40mg,
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mild fever (99.1-99.5), body aches, chill started about 12 hours after receiving injection. Treated with alternating doses of acetaminophen and ibuprofen. Was tired the next day. The symptoms started to dissipate after 24 hours and were gone after 30 hours.


VAERS ID: 1201902 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Menstruation irregular, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Fertility disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: pt says her right arm hurt for a couple of days since taking the vax and has become very fatigued. She had some chills and nausea. She then started feeling like she was going in and out of consciousness. This happens when she has not have enough sleep since due to the fatigue. She says she started her menstrual cycle and it is much heavier than normal and came two week early. She says she still has these symptoms and is concerned.


VAERS ID: 1201967 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-04-09
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Headache, Intensive care, International normalised ratio increased, Magnetic resonance imaging head abnormal, Platelet count decreased, Prothrombin time prolonged, Scan with contrast abnormal, Superior sagittal sinus thrombosis, Transverse sinus thrombosis, Venogram abnormal, Vomiting
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No prescriptions, OTC, dietary supplements o herbal remedies
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: (1) 4/12/21, MRI venogram sagital sinus wo contrast: "Findings suggest thrombosis of the superior sagittal sinus and transverse sinuses and straight sinus. There is no significant flow in the sigmoid sinuses and jugular vein may be related to decreased flow and/or thrombosis as well." (2) 4/12/21, MRI Brain w wo contrast: "Findings suggesting a diffuse transverse and sigmoid sinus thrombosis. Poor of flow void visualization of the jugular veins as well and is possible these could be occluded as well. No prominent hematoma is detected but on the gradient echo sequences there is prominent diminished signal in the sulci bilaterally and this can be seen in minor of subarachnoid hemorrhage. No midline shifting or mass effect is detected." (3) 4/12/21, Protime=15.4 sec (4) 4/12/21, INR=1.2 (5) 4/12/12, PLT= 64 k/uL
CDC Split Type:

Write-up: 36 y.o. female referred for the above chief complaint. She has no significant medical history and presented with a headache that became severe 3 days ago. She received the Johnson and Johnson COVID vaccine on March 25th and had a mild headache following that which she attributed to the vaccine. 3 days ago the pain became excruciating and was associated with vomiting. This prompted presentation to the ED where she was treated with Dilaudid. She was discharged home and has been using her mom''s headache cocktail with some transient relief. She presented back to the ED today with continued symptoms. MRV revealed a venous sinus thrombosis and neurology was therefore consulted. She has no history of clots personally or in the family. Her dad did have a stroke in his 50s. Patient otherwise denies any other associated speech change, vision change, extremity numbness, extremity weakness, coordination difficulty, or dizziness. Patient admitted to the neurology ICU and started on anticoagulation.


VAERS ID: 1202076 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Caltrate, vitamins, FiberCon, Pravastatin, Lisinopril, Detrol, Pantoptazole
Current Illness: None
Preexisting Conditions: None
Allergies: Percocet, Cats
Diagnostic Lab Data: Did not see medical assistance.
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA About 1-1/2 hours after injection I became very light headed. I sat down for a couple of hours and it went away. That night I could not sleep. I only had about 3 hours of on-and-off sleep through the night. One time I woke up with severe chills The following day (Saturday) I had a lack of energy and in the afternoon I was running a low grade fever (99.8). Went to bed around 8:30 Saturday night, slept all night and felt fine Sunday morning.


VAERS ID: 1202094 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol inhaler as needed, Fluoxetine 40mg daily noon
Current Illness: none
Preexisting Conditions: asthma, COVID-19 positive 11/2/20
Allergies: cephalosporins
Diagnostic Lab Data: 4/9/21 ER evaluation at Medical Center. Vital signs were monitored and patient assessed. No labs or xrays needed. Patient was discharged on 4/9/21 0404.
CDC Split Type:

Write-up: The patient was found lying on the floor face down at 2:40am. He was responsive and able to sit up. Reported dizziness and chills. Was visibly shaking while staff were talking with him. Was sent to the ER for evaluation.


VAERS ID: 1202129 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Limb discomfort, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Foot heaviness, pain infrequently in right and left pain. rotating pain in the body ( abdominal, leg, arm). Dizziness for 5-6 hours on 04/12/2021. It subsided afterwards. Breathlessness for 3-4 days.


VAERS ID: 1202142 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-06
Onset:2021-04-09
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test abnormal, Dizziness, Dyspepsia, Dyspnoea, Echocardiogram, Electrocardiogram, Flushing, Myocardial infarction, Nausea, X-ray
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D3
Current Illness: none
Preexisting Conditions: overweight
Allergies: none
Diagnostic Lab Data: Emergency Room and Urgent Care. I had an EKG, blood work and a heart x-ray Hospital - I had multiple EKGs, cardiac angioplasty and echocardiogram
CDC Split Type:

Write-up: Shopping, climbed a single level stairway, became winded, nauseous, got bad heartburn feeling, felt flush and started getting dizzy. Took Tums, no help went to Emergency Room and was told that there was an enzyme in my blood which showed I had a heart attack


VAERS ID: 1202163 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Dyspnoea, Headache, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Severe headache, shortness of breath, stomach ache, diarrhea, minor leg pain, moderate all-body soreness. Symptoms have abated except for headache and shortness of breath. These have only reduced in severity.


VAERS ID: 1202165 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Dizziness, Fall, Hot flush, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81mg daily, Tums as needed, Vitamin D 1000 units daily, estradiol 2mg BID, spironolactone 50mg daily noon, loratadine 10mg daily as needed
Current Illness: none
Preexisting Conditions: gender dysphoria on hormone therapy, environmental allergies, history of lap chole, COVID-19 positive 10/15/20
Allergies: none
Diagnostic Lab Data: nursing assessment only. No labs or xrays. No ER visit needed
CDC Split Type:

Write-up: Patient stood for count in the prison and blacked out. Fell and lost conciousness for approximately 2 seconds. Reported since "this am" he had been experiencing weakness, joint aches, hot flashes, and nausea. Reports he is dizzy. BP 108/64, HR 84, RR 16, O2 sat 96% room air. Was given tylenol and advised to rest.


VAERS ID: 1202200 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chills, Dehydration, Diarrhoea, Dizziness, Dry mouth, Fatigue, Headache, Injection site pain, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Multivitamin, magnesium 500mg, Flaxseed oil 1,000mg, glucosamine chondroitin, fexofenadine hydrochloride
Current Illness: No
Preexisting Conditions: no
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: For Two days following vaccine: Fever, chills, body aches, headache, fatigue, nausea, muscle pain, dizziness, dry mouth dehydration, pain at injection site For Four days following vaccine: fatigue, dizziness, abdominal pain, diarrhea, nausea, pain at injection site. Pain at injection site is ongoing


VAERS ID: 1202206 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Clubbing, Dyspnoea, Panic attack, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Hx kidney infection.
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Clubbing of fingers and toes, tackycrdia, labored breathing, 122/90, Resp. 24, HR 100. Pt. observed with clubbing of fingers, anxiety, panic attack, Emergency Personnel was notified and patient was transferred to Hospital for further evalution.


VAERS ID: 1202239 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Headache, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: Penicillin, sulfa, latex, wheat
Diagnostic Lab Data: None to date.
CDC Split Type:

Write-up: I had extreme chills beginning at 5:00 pm, then fever and vomiting for six hours the day of the vaccine. The day following I was tired and had a headache. Now on April 13, I feel better but still tired and my breathing feels heavy but I am giving it some time for improvement.


VAERS ID: 1202263 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Contusion, Fall, Head injury, Seizure, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Client reported she was getting over a cold - cough and runny/stuffy nose
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 8 minutes after vaccination client fell and hit her head, she has a large lump to right side of her head. After hitting the floor patient begin to show seizure activity for about 1-2 minutes. BP 140/20 P62. Ambulance service on site and transported to Hospital for follow up care.


VAERS ID: 1202265 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Pyrexia, Sleep disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Men''s Daily Vitamin & store brand Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: - Woke up in the middle of the night following the day of my shot, approximately 14 hours after injection, to the shivers. Whole body shaking, almost feverish, but without running a temperature. - Severe fatigue the entire two days following the injection. Slept for 21 hours beginning on noon the day following the shot until 9am the following day. - Mental haziness/fogginess three days after injection. Felt as if I was buzzed without having consumed any alcohol.


VAERS ID: 1202270 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Pain in extremity, Sleep disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: Fluoxetine 10 mg Bupropion 100mg Vitamin D3
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Did not contact medical help at that time. But have messaged my Doctor since, after hearing reports on news of J & J vaccine and blood clots in women. Waiting to hear back now.
CDC Split Type: 203A21A

Write-up: Awakened earl y morning 12:00 am of April 9th with horrible pain in left calf of leg. Pain continued throughout the night, until I finally got up and just walked around house to try to get some relief then laid down and try elevating leg on pillows. The pain continued so got u p and walked around more and pain finally subsided enough to get some rest. Then felt like just had a bruise in that area of the leg for a day.


VAERS ID: 1202290 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arteriosclerosis, Blood cholesterol normal, Blood triglycerides increased, Cardiolipin antibody, Cerebral artery occlusion, Cerebrovascular accident, Embolism, Hemiparesis, High density lipoprotein decreased, Low density lipoprotein increased, Magnetic resonance imaging head abnormal, Non-high-density lipoprotein cholesterol increased, Platelet count normal, Thrombectomy
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic 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), Lipodystrophy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Budesonide 3 mg EC capsules - 1 capsule PO every other day Simpesse (norethindrone/ethinyl estradiol) - 1 tablet PO daily Ditropan 5 mg tablets - 1 tablet PO BID Montelukast 10 mg - 1 tablet daily
Current Illness: unknown
Preexisting Conditions: Down syndrome Autism Deaf
Allergies: Cefaclor - unknown reaction Sulfamethoxazole/trimethoprim - unknown reaction
Diagnostic Lab Data: Brain CTA - large M1 branch occlusion Angiogram - bilateral chronic atheroschlerotic disease MRI brain - shows acute and old strokes. Patient''s parents stated patient did NOT have a known history of strokes. Platelets - range from 192 on admission to 306 Anti-cardiolipin IgG/IgM antibody - pending Total cholesterol - 181 Triglycerides - 134 LDL - 112 Non-HDL 139 HDL - 42
CDC Split Type:

Write-up: Patient presented to hospital on 4/9/21 - 4 days post vaccination - with new onset left sided weakness. Brain CTA showed a M1 branch occlusion. Patient was given TPA and transferred to Medical Center for further management and mechanical thrombectomy. Successful thrombectomy done. Etiology of stroke cryptogenic but suspect emoblic event. Questionable moyamoya disease - notes state "if moyamoya suspect, patietn will get neurosurgery survice on board/appreciate neuro recommendations"


VAERS ID: 1202307 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-08
Onset:2021-04-09
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Hypertension, Inflammation, Insomnia, Pain, Pain in extremity, Renal pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 2.5 mg daily
Current Illness: None
Preexisting Conditions: NKA
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1ST DAY=Heachache, Dizzines, High blood pressure, Inflamation of hands. 2ND DAY= High blood pressure, headache, chills 3RD Day: Headache, kidney pain 4th Day: Headache, body ache. 5th day: Heachache, leg pain, can''t sleep.


VAERS ID: 1202330 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Per patient he had some swelling and was unable to walk for several hours since has resolved


VAERS ID: 1202336 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Malaise, Muscle spasms, Muscle twitching, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Dyskinesia (broad), Dystonia (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: NP Thyroid 90mg
Current Illness: NONE
Preexisting Conditions: Hyperthyroidism
Allergies: Sulfa drugs
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA 4-9-21: Unusual and painful muscle cramps in both legs and left foot/ Nausea/ Vomiting random muscle twitching through out trunk and legs. Cramps ending by mid morning. In general not feeling well through out day. 4-10-21 onset of severe to mild headache. Again, general not feeling well. All days following moderate headache. To this date 4-13-21 not feeling back to self 100%.


VAERS ID: 1202346 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, 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: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shot administered at 1:30 pm, onset of symptoms at 8:00pm fever, chills,, body aches, nausea. Severe for 10 hours, then just general soreness and feeling tired.


VAERS ID: 1202422 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

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

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

Write-up: Patient states she has leg pain behind the knee area on both legs starting 2 days after vaccination. She called into pharmacy today stating that she still has pain in both legs but it is more prominent on left leg. She called her physician who told her to call the pharmacy. Advised patient to schedule follow up visit or proceed to urgent care.


VAERS ID: 1202472 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A 21A / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Feeling cold, Headache, Hot flush, Migraine, Neck pain, Pain, Pain in jaw, Skin sensitisation, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Osteonecrosis (broad), Arthritis (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: amitriptyline, Sertraline, phentermine
Current Illness: none at time of vaccine, month prior migraines
Preexisting Conditions:
Allergies: keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: sudden sharp pain on left side, severe body pain especially in neck and shoulders, hot/cold flashes, migraine, headache, severe fatigue, blurry vision, skin sensitivity to touch, body aches, back pain so bad couldn''t stand straight, jaw pain. currently on day 5 of symptoms. called doctor they advise to just watch symptoms


VAERS ID: 1202521 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Decreased appetite, Feeling cold, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Saw palmetto, fish oil, protein powder, folic acid, chondroitin, garlic oil, vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, sever chills for 2 hours, sustained heart rate around 90~100 for more than 4 hours, intermittent headaches 24 hours, mild confusion for 4 hours, loss of appetite for 48 hours


VAERS ID: 1202536 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Headache, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, amitriptyline, simvasatin, tizanadine,
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Very horrible headache, like I have never felt before, low grade fever, shortness of breathe, fatigue, body aches


VAERS ID: 1202621 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Hypoaesthesia, Movement disorder, Pain in extremity, Paraesthesia, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), 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: Influenza- age 11 or 12, L arm soreness/localized and severe headache
Other Medications: Meloxicam, Ventolin HFA, Tylenol
Current Illness: none
Preexisting Conditions: Asthma
Allergies: Ibuprofen- shortness of breath History of severe headache and arm soreness with flu immunization
Diagnostic Lab Data: Cervical XRay-4/13
CDC Split Type:

Write-up: Left arm numbness and tingling from shoulder to tips of fingers, developed 1-2hr after immunization, constant, unresolved; other symptoms include vomiting, diarrhea, and entire arm soreness (unable to raise arm)


VAERS ID: 1202639 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-04-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A2 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blindness unilateral, Cerebrovascular accident, Computerised tomogram head abnormal, Thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data: Ct scan. Labs assent. I am in the stroke unit.
CDC Split Type:

Write-up: Develop a blood clot lost vision in left eye due to stroke. I?m still in the hospital. I am 50 and had a stroke a week at getting that vaccine TPA shot. Given. Clot buster


VAERS ID: 1202714 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zyrtec, progesterone only contraception, flonase, Vit D3, sertraline
Current Illness: n/a
Preexisting Conditions: asthma
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache X 24 hours. Rigors, low grade fever, nausea X 1 hour 12 hours after injection. Improved with tylenol. Fever of 101 at hour 36.


VAERS ID: 1202730 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Diarrhoea, Fatigue, Headache, Injection site warmth, Nausea, Pain, Pain in extremity, Paraesthesia, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, cymblalta, multi-vitamin
Current Illness: n/a
Preexisting Conditions: arthritis
Allergies: morphine, codeine. penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 04/09/21 @ 2:07 PM - I started itching and tingling all over by body. Heated tingle feeling shooting down from injection site and across shoulder and neck to the right side. Rash on my back and lower back pain. 04/10/21 @ 4:30 AM - I woke up with a pounding headache, body ache to include muscles and joints, and nausea. This was off and on and subsided the morning of 04/13/21 04/10/21 - started have pain and cramps in my left calf and I am fatigue. Both which still continues as of now. 04/11/21 - stomach cramps and diarrhea I have taken Advil and Tylenol. I called the Health Department and doctors office. Was told to take Benedryl.


VAERS ID: 1202753 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-03
Onset:2021-04-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Headache, Musculoskeletal stiffness, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

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

Write-up: Very bad headache Knot on arm where vaccine was given Neck stiffness


VAERS ID: 1202790 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood pressure normal, Blood test normal, Chest X-ray normal, Computerised tomogram normal, Confusional state
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vitamins; Zyrtec D - occasionally
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood work, x-ray of chest, CT scan or brain and chest/heart area, blood pressure was fine and all test came back normal
CDC Split Type:

Write-up: memory loss of all events that happened that day. For a 3 hour period patient could not remember what had happened that day at work, his appointments after work, that he had gotten hearing aids 2 weeks prior and that he had ever seen or worn hearing aids. He was very confused for about 3 hours. I called our doctor and he advised me to take him to the ER, it took me 45 minutes to get him there and by that time his memory was back. He has never had a problem like this before and I thought he might be having a stroke or something. there was definitely something severely wrong.


VAERS ID: 1203188 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI/MRA scheduled 4/16/2021
CDC Split Type:

Write-up: Subjective fever, chills, headache, nausea, fatigue


VAERS ID: 1203264 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling cold, Headache, Pain
SMQs:

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

Write-up: Chills and shivering before bed, (could not get warm). Lasted until morning 10APR. Headache in the AM 10APR. Lasted a few hours. Achy feeling all over. Very tired. Lasted until morning 11APR.


VAERS ID: 1203270 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin 20 mg, Olmesartan 40 mg Vitamin D3, Zinc, C
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fainted twice, some body shakes when waking up, glazed over eyes


VAERS ID: 1203271 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose abnormal, Dizziness, Dyspnoea, Fatigue, Gait disturbance, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (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: Oxycodone, Robaxin, Ambien, Cymbalta, Lyrica, Buspirone, lorsartan declined to give other. Says she''s on 30 medications and supplements
Current Illness:
Preexisting Conditions: Hypertension, Diabetes II (insulin pump), fibromyalgia, chronic back, neck and knee pain, chronic migraines
Allergies: Myrbetriq - legs swell; Baclofen - "body shuts down" - gets very sleepy, confused, shaky; Morphine- respiratory failure, kidney failure - almost died - thought it was a reaction between lisinopril and Morphine.
Diagnostic Lab Data: Messaged her doctor what went on, but they didn''t get back to her.
CDC Split Type:

Write-up: On 4/9/2021 - about one hour after vaccine, had difficulty breathing and dizzy. Someone helped her to the car. Had to wait in the car about an hour before she felt well enough to drive. Checked her blood sugar while she was in the car and it was 75 (she had drank half of a Coke.) Usually runs around 200. Otherwise she had usual symptoms, sore swollen arm, fatigue.


VAERS ID: 1203351 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

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

Write-up: 103 temp, aches, chills and severe headache


VAERS ID: 1203355 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Oral herpes, Pain
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Vestibular disorders (broad), Opportunistic infections (broad)

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

Write-up: 8pm: Sharp, shooting pains in my head (similar to shingle pain). 3am on 04/10/21: Extreme fever, chills, body pains so intensive that I was screaming for over an hour, could not put a sheet on my body to warm up because the weight of the sheet caused more pain. This occurred for several hours. When finally able to stand upright, I was too dizzy to stand until approximately 12pm on 04/10/21. Symptoms subsided and appeared to be gone by 8pm on 04/10/21.


VAERS ID: 1203446 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Age 17 years 11 months


VAERS ID: 1203447 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / IM

Administered by: School       Purchased by: ?
Symptoms: Dizziness, Muscle spasms
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 150mg Wellbutrin 150mg
Current Illness:
Preexisting Conditions:
Allergies: Dust extract Mold
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Around 2:30pm on 4/9/21 (one day after vaccination) I got a Charlie horse in my right calf. I didn?t think much of it. About 20 minutes later when trying to get out of bed I got another Charlie horse in my left calf this time. This one was much more painful and intense. After it let up I laid there for a little longer and tried to get up when my leg calf, again, got another Charlie horse in the same place. This happened a total of 4 times, back to back to back to back. Each Charlie horse I had in my left calf was especially intense and painful, worse than any Charlie horse I?d ever had before. I don?t get Charlie horses often, but I have been a lifetime athlete so I?m familiar with the feeling. I had not previously worked out in the days leading up to my vaccine. I?m not even sure this is an adverse effect of the vaccine, I just didn?t know if anyone had had a similar reaction and have been made aware that blood clots have also been a concern with the J&J vaccine. I?m also unsure if my Zoloft, which has a warning that it may cause dizziness, may have reacted with the vaccine to make me incredibly dizzy. But around 04:00am on 4/9/21 (I work night shift) I became increasingly dizzy making it difficult to perform the tasks at hand. Enough so that I had to sit down and even reading words off a computer screen made me dizzy. I couldn?t drive home from work at 07:30am that morning because I was concerned with my dizziness. It had subsided by the time I woke up at 02:00pm later that day.


VAERS ID: 1203470 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: SHRIMP, LOBSTER, CEPHALOSPORIN, ERYTHROCIN
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving the Johnson & Johnson vaccine at noon on April 9, at around 11:30 that evening, symptoms of muscle pain and fever began to appear throughout the body. When lying down in the middle of the night, I experienced severe shortness of breath. The above situations lasted for 2 days. It began to ease on April 13, and there are still fever symptoms now.


VAERS ID: 1203493 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Nausea, Pain, Pain in extremity, Pyrexia, Rash, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: CHILLS, FEVER, LEG PAIN GETTING WORSE, NAUSEA, RASH, BODY ACHES


VAERS ID: 1203504 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis, Hypotension, Pallor, Pulse abnormal
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt reports taking an over the counter allergy medication but due to language barrier it is unclear which
Current Illness: No medical conditions reported
Preexisting Conditions: No medical conditions reported
Allergies: NKDA
Diagnostic Lab Data: None reported
CDC Split Type:

Write-up: Presented with 27 YO male, seated in a chair S/P receiving Johnson and Johnson COVID-19 vaccine. PT started to feel dizzy and started to become diaphoretic. PT does not speak English, upon translator?s arrival they advised this writer that PT was feeling dizzy, and short of breath. PT visibly diaphoretic and his skin color changing from normal to pale. PT pulse weak and thready, and PT hypotensive at 76/P. PT administered 50mg of Benadryl IM in his right deltoid, successful. PT pulse no longer palpable in the radial so PT placed in a supine position on the floor and PT legs elevated to a Trendelenburg position for his hypotension. PT administered 1mg Epinephrine 1:1,000 IM in the left deltoid, successful. Ambulance called for transport of the PT to the nearest hospital. PT blood pressure slowly starting to stabilize at 90/56. PT SPO2 reading 98% on room air with respirations 18 and regular with clear lung sounds. PT no longer having Shortness of breath or dizziness. PT no longer sweating and he is beginning to stabilize. Radial pulse palpable again and strong and regular at a rate of 76 bpm. PT blood pressure reading 110/76. Upon fire department arrival determined that the PT was stable enough to sit upright in the chair again. PT was assisted off the floor and to a seated position in a chair. PT vitals after seated position for 5-7 min, BP 120/82, pulse 86 strong and regular, RR 20 and clear equal bilateral lung sounds. PT has no other complaints at this time. PT has no allergies to medication, PT has a pollen allergy that he takes over the counter allergy medicines for. PT has no past medical history. Upon arrival of ambulance PT care relinquished to EMS with full report, PT care relinquished without incident or injury.


VAERS ID: 1203505 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: fainted


VAERS ID: 1203532 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Fatigue, Headache, Intermenstrual bleeding, Menstruation irregular
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Fertility disorders (broad)

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

Write-up: Chest Pains 24 hours after vaccine. Lasted two days. No Treatment. Went away on its own. Sharp Stomach Cramps 48 hours after vaccine- 04/09-No Treatment. Ended 04/13. Irregular Menstrual Cycle. Period not due for 3 weeks and started in middle of birth control packet (Lo Loestrin Fe (doesn''t usually have a normal flow of blood on birth control)- 04/11 coupled with fatigue and headache. It is 04/13 and am currently still bleeding.


VAERS ID: 1203563 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis, Pallor, Skin discolouration, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Presented with 28 YO male, seated in a chair S/P receiving the Johnson and Johnson COVID-19 vaccine. PT states he was feeling dizzy with shortness of breath. PT was given a bottle of water by RN for hydration. PT skin color starting to change from normal to a pale and PT started to become diaphoretic. Ambulance notified for transport to the closest facility. PT pulse 70 and strong and regular, BP 100/60 and respirations 20 strong and regular. PT denies any medical history or allergies at this time. No other interventions performed with PT due to ambulance arrival and PT care relinquished to EMS with full report, PT care relinquished without incident or injury.


VAERS ID: 1203579 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Facial pain, Fatigue, Headache, Hyperhidrosis, Inflammation, Injection site swelling, Neck pain, Pain, Pain in jaw
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Osteonecrosis (broad), Arthritis (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: Pristique, Birth control, xanax
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: seen doctor on 04/12 for the pain going on left side of face, will continue heat, ibuprofen and started a steroid for inflammation.
CDC Split Type:

Write-up: started on 04/09/2021- severe body aches, sweats, chills, severe headaches, pain on left side of face that ran down jaw and into middle of neck, swelling of injection site, sever fatigue. some symptoms are still ongoing.


VAERS ID: 1203583 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chills, Fatigue, Headache, Hypoaesthesia oral, Nausea
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Postnatal Multi + 200 mg DHA Softgels (Nature Made) Colace (100mg) Sertraline (50mg)
Current Illness: None
Preexisting Conditions: Recurrent respiratory infections
Allergies: Seasonal allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache, nausea, fatigue, chills, and feelings of anxiety began at approx 5PM 4/8/2021- treated with 1000mg acetaminophen at 5PM and again at 11PM. Lingering headache on 4/9/2021- treated with 200mg ibuprofen 11AM and again at 4PM. Tongue numbness began 12:30PM on 4/9/2021. Numbness was initially located on both sides and began to affect the lips at 3PM. Numbness was localized to the right side of the tongue by 8AM 4/10/2021 and still persists as of 2PM 4/13/2021. No treatment sought.


VAERS ID: 1203607 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Chills, Headache, Injection site pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 4/9/21 = 9pm EST, 102 fever, severe chills, back ache, pain at injection site, minor stomach pain 4/10/21 = 9am EST, headache 4/10/21 = 9pm EST, 101.5 fever, chills, back ache 4/11/21 = 9pm EST, 100 fever


VAERS ID: 1203638 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Chills, Headache, Nausea, Pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, B complex, turmeric, biotin, collagen powder
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Upon injection, arm was wobbly and felt like fire, and sore. This faded quickly during the 15 minute observation period. No symptoms presented until later in the evening and included a fever of 99-101, chills, body aches, headache, nausea, and vomiting.


VAERS ID: 1203652 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-30
Onset:2021-04-09
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Cold sweat, Fatigue, Headache
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: During the night as the same day I get headaches, feel tiredness and have stomach upset. Them at next Friday, the same week may 2, 2021 I start to fell more tired, cold sweat and stomach hurts. Since that day my pain increase, my stomach swelling and I can''t go to the bathroom. Yesterday I make an appointment the doctor send me Polyethylene Glycol 3350NF, Colace 100 mg and Clobetasol .05%. I have an appointment with doctor for 1rst time to see what''s wrong with me.


VAERS ID: 1203692 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chills, Cold sweat, Eye movement disorder, Feeling cold, Headache, Hyperhidrosis, Impaired work ability, Nausea, Nervousness, Vision blurred
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ritalin Wellbutrin (Weaning off Depakote and Lexapro as of two weeks) Ambien as needed to sleep Vitamin gummies
Current Illness: No
Preexisting Conditions: Anxiety Depression ADHD
Allergies: No
Diagnostic Lab Data: I did not visit a doctor for this.
CDC Split Type:

Write-up: Seizure-like incident while at a restaurant. Eyes rolled back in to my head, according to my friend who was with me. My vision got blurry, I started feeling nauseous, shivers, cold sweats, body felt shaky, and at first I thought I had been drugged. This "attack" lasted for a couple of minutes. After being able to get home I was in bed until 4 pm the next day. At first I had several hours where I was freezing despite being in bed fully dressed with the heat blasting, the following hours, I was sweating. I had a headache, felt nauseous, and uncomfortable all day Saturday. My reaction to the vaccine was much worse than having Covid-19. Missed work due to the symptoms from getting the vaccone.


VAERS ID: 1203731 (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: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Hypoaesthesia, Musculoskeletal stiffness, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Arthritis (broad)

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

Write-up: Numbness/cold in legs. Numbness in arm and one finger of vaccinated arm. Tightness of throat and upper back pain.


VAERS ID: 1203746 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0141A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None listed
Current Illness: None noted
Preexisting Conditions: Chronic insomnia
Allergies: Shrimp, eucalyptus, dust, mold
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had her vaccine at 1835 and then proceeded to the monitoring area for her 30 minutes of monitoring due to allergy hx. At 1800 pt reported itchiness over her chest and left leg to monitoring RN. RN noted no other symptoms. Pt provided with diphenhydramine 25mg PO. RN continued to monitor. No added complaints and pt discharged home at 1850 feeling better.


VAERS ID: 1203750 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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 reported.
Current Illness: None reported.
Preexisting Conditions: None reported. Patient states that she is healthy and not on any medications.
Allergies: None reported.
Diagnostic Lab Data: She did not have any medical tests or laboratory results.
CDC Split Type:

Write-up: Patient states that she had ear, cheek bone, some teeth and chin numbness. It started on the car ride home after the 15 minute period of sitting by pharmacy for evaluation. Pt said it was about 25 minutes after vaccine. The numbness was only on the left side of her face. The vaccine was also in the left arm. She said her symptoms had completely resolved after 24 hours.


VAERS ID: 1203761 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache, Hypoaesthesia, Hypoaesthesia oral, Pyrexia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), 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: Allegra allergy medication, Junel FE birth control
Current Illness: N/a
Preexisting Conditions: PCOS
Allergies: N/a
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: About 8 hours after receiving my shot, I developed a fever and chills. Then shortness of breath and a headache. For a short period of time, the left side of my lips (upper and lower), and my left hand went numb. These adverse side effects lasted about 15 hours.


VAERS ID: 1203821 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, 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: Eliquis, metoprolol, losarten, furosemide,rosuvastatin, chewable asprin
Current Illness:
Preexisting Conditions: Heart problems
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in legs


VAERS ID: 1203831 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0141A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Paraesthesia oral
SMQs:, Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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: Amitriptyline, losartan, methotrexate, Incruse ellipta, Symbicort, Bystolic, pioglitazone, Januvia, exetimibe, wellbutrin. Rituxan tx
Current Illness:
Preexisting Conditions: Rheumatoid arthritis, polymyositis, type-II DM, asthma
Allergies: Biaxin, Bactrim, zithromax, Augmentin, Remicade
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had her vaccine at 1550pm and then proceeded to the monitoring area for her 30 minutes of monitoring. At 1620 she complained to the monitoring RN of tongue tingling and a flushed feeling. RN provided pt with diphenhydramine 25mg PO x 1 and water. Pt noted slow and continued improvement of symptoms. Pt monitored longer and discharged to home at 1635.


VAERS ID: 1203843 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamsulosin 0.4mg
Current Illness: None Reported
Preexisting Conditions: Enlarged Prostate
Allergies: NKDA
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient did not inform the pharmacy that he had previously received the Moderna Covid 19 vaccine. He filled out our questionnaire/screening checklist and indicated he had not received a vaccine. Prior to administering the vaccine the patient was informed he would be getting Janssen Covid 19 vaccine and that it was indicated for 1 dose. He did not inform us that he had received Moderna so Janssen was administered and documented. As of right now, I have not been informed of any adverse reactions that the patient has had.


VAERS ID: 1203850 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Disorientation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (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: none
CDC Split Type:

Write-up: Loss of vision for approximately 30 minutes & disorientation.


VAERS ID: 1203854 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-06
Onset:2021-04-09
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vyvanse 20mg zoloft 100 mg
Current Illness: none
Preexisting Conditions: none
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: about 4 weeks after my shot I started a post menopausal cycle after 6 years without a period


VAERS ID: 1203859 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-04
Onset:2021-04-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase, Albumin globulin ratio, Aspartate aminotransferase, Bacterial test, Bilirubin urine, Blood albumin, Blood alkaline phosphatase, Blood bilirubin, Blood calcium, Blood chloride, Blood creatinine, Blood glucose, Blood lactic acid, Blood potassium, Blood sodium, Blood urea, Blood urine absent, Carbon dioxide, Chromaturia, Confusional state, Culture urine, Dyspnoea, Glomerular filtration rate, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Influenza virus test, Lymphocyte count normal, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume normal, Mean platelet volume increased, Mental status changes, Metabolic function test, Monocyte count increased, Monocyte percentage increased, Neutrophil count increased, Nitrite urine absent, Nucleated red cells, Platelet count normal, Procalcitonin normal, Protein total, Protein urine absent, Pyrexia, Red blood cell count decreased, Red blood cells urine positive, Red cell distribution width normal, SARS-CoV-2 test negative, Specific gravity urine normal, Urinary incontinence, Urinary sediment present, Urine abnormality, Urine ketone body absent, Urine ketone body present, Urine leukocyte esterase positive, Urobilinogen urine increased, White blood cell count increased, White blood cells urine positive, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Proteinuria (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), COVID-19 (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: Current Outpatient Medications: ? ARIPiprazole (ABILIFY) 2 MG tablet, Take 1 tablet (2 mg) by mouth daily, Disp: 30 tablet, Rfl: 1 ? citalopram (CELEXA) 40 MG tablet, Take 1 tablet (40 mg) by mouth daily, Disp: 90 tablet, Rfl: 3 ? diclo
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CBC W AUTO DIFF Collection Time: 04/13/21 9:46 AM Result Value Ref Range White Blood Cell Count 11.7 (H) 4.3 - 10.5 THOUS/uL Red Blood Cell Count 4.13 3.93 - 5.07 MIL/uL Hemoglobin 13.4 11.8 - 14.8 GM/DL Hematocrit 38.3 35.6 - 45.0 % Mean Corpuscular Volume 92.7 83.5 - 95.9 FL Mean Corpuscular Hemoglobin 32.4 (H) 27.4 - 32.0 PG Mean Corpuscular Hemoglobin Conc 35.0 (H) 31.5 - 34.7 G/DL Rdwcv 13.6 11.8 - 14.2 % Rdwsd 46.4 37.2 - 47.8 FL Platelet Count 179 167 - 402 THOUS/uL Mean Platelet Volume 11.1 8.8 - 12.0 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Seg 82.0 (H) 39.9 - 72.2 % Lymphs 9.0 (L) 20.4 - 48.6 % Monocytes 9.0 5.0 - 11.5 % Neutrophils Absolute Count 9.5 (H) 1.7 - 8.3 THOUS/uL Lymphocytes Absolute Count 1.1 0.8 - 5.3 THOUS/uL Monocytes Absolute Count 1.1 (H) 0.1 - 1.0 THOUS/uL Diff Comment VERIFIED FROM SLIDE SCAN Differential Type AUTO Platelet Estimate ADEQUATE ADEQUATE COMPREHENSIVE METABOLIC PANEL Collection Time: 04/13/21 9:46 AM Result Value Ref Range Glucose SENT TO REFERENCE LAB 65 - 100 MG/DL Blood Urea Nitrogen SENT TO REFERENCE LAB 7 - 18 MG/DL Creatinine SENT TO REFERENCE LAB 0.5 - 1.0 MG/DL Sodium SENT TO REFERENCE LAB 136 - 145 MMOL/L Potassium SENT TO REFERENCE LAB 3.5 - 5.1 MMOL/L Chloride SENT TO REFERENCE LAB 98 - 107 MMOL/L Co2 SENT TO REFERENCE LAB 21 - 32 MMOL/L Calcium SENT TO REFERENCE LAB 8.5 - 10.1 MG/DL Protein Total SENT TO REFERENCE LAB 6.4 - 8.2 G/DL Albumin SENT TO REFERENCE LAB 3.4 - 5.0 G/DL A/G Ratio NOT CALCULATED 0.8 - 2.0 Alkaline Phosphatase SENT TO REFERENCE LAB 46 - 116 U/L Alt (SGPT) SENT TO REFERENCE LAB 14 - 59 U/L AST(SGOT) SENT TO REFERENCE LAB 15 - 37 U/L Bilirubin, Total SENT TO REFERENCE LAB 0.2 - 1.0 MG/DL GFR Comment PENDING Est GFR UNABLE TO CALCULATE $g90 ML/MIN/1.73sq.m PROCALCITONIN Collection Time: 04/13/21 9:46 AM Result Value Ref Range Procalcitonin 0.12 (H) <0.10 NG/ML Procalcitonin Normals GENERAL COMMENTS Antibiotic initiation should not be withheld for patients with sepsis or pneumonia with radiographic evidence of infiltrates. A low procalcitonin should prompt the investigation of non-bacterial or non-infectious causes of patient clinical status. Repeat low or declining procalcitonin ($g80% from peak) may indicate an opportunity for antibiotic de-escalation or discontinuation. Low procalcitonin levels in the presence of acute bronchitis, COPD exacerbations, and other related conditions generally indicates the absence of clinically significant bacterial infections. Please refer to the procalcitonin guidance document. LACTIC ACID, SERUM Collection Time: 04/13/21 9:47 AM Result Value Ref Range Lactate 5.3 (H) 0.4 - 2.0 MMOL/L URINALYSIS WITH REFLEX TO CULTURE, IF INDICATED Collection Time: 04/13/21 9:48 AM Specimen: URINE,CLEAN CATCH (CCMS) Result Value Ref Range Glucose UA 3+ (A) NEGATIVE MG/DL Protein UA NEGATIVE NEGATIVE MG/DL Bilirubin UA NEGATIVE NEGATIVE Urobilinogen UA $g7.9 (H) 0.2 - 1.0 MG/DL pH UA 6.0 5.0 - 8.0 Blood UA TRACE (A) NEGATIVE Ketones UA NEGATIVE NEGATIVE MG/DL Nitrite UA NEGATIVE NEGATIVE Leukocyte Esterase UA TRACE (A) NEGATIVE UR Appearance CLOUDY (A) CLEAR Specific Gravity UA 1.010 1.000 - 1.030 Color YELLOW YELLOW Site CCMS Comment, Urine Culture IN PROGRESS RBC Urine 6 to 10 <3 /HPF WBC Urine 51 to 100 <5 /HPF Bacteria MODERATE (A) NONE /HPF Squamous Epithelial FEW <5 /HPF URINE CULTURE Collection Time: 04/13/21 9:48 AM Specimen: URINE,CLEAN CATCH (CCMS) Result Value Ref Range Specimen Type CCMS Special Handling NONE Reflexed from T69900 Culture Result PENDING Specimen Status Report PENDING ACETONE Collection Time: 04/13/21 9:50 AM Result Value Ref Range Acetone Serum SMALL (A) NEGATIVE NOVEL CORONAVIRUS SARS-COV-2 BY NAA Collection Time: 04/13/21 10:12 AM Result Value Ref Range Novel Coronavirus SARS-COV-2 by NAA NEGATIVE NEGATIVE
CDC Split Type:

Write-up: 68 y.o. female who presents with FEVER, ALTERED MENTAL STATUS, URINARY INCONTINENCE. DAUGHTER STATES INCONITNENCE STARTED Friday 4/9 AND FEVER AND CONFUSION STARTED TODAY WITH SHORTNESS OF BREATH. PT WAS SEEN AND SWABBED FOR COVID AND FLU BUT REFERRED TO ER FOR FURTHER EVAL AND WORKUP. PT IS DIABETIC BUT DAUGHTER REPORTS NOT KNOWING WHERE ACCUCHECKS ARE AS THEY HAVE NO MONITOR AT HOME. Admitted Inpatient 4/13/21


VAERS ID: 1203874 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy to vaccine, Chills, Headache, Hypersensitivity, Lethargy, Pain, Pyrexia, Rash, Renal pain, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone Estradiol Progesterone Gabapentin Saw Palmetto Collagen Vitamin D Vitamin c Zinc Iron Biotin
Current Illness: No, but had covid 2 months prior.
Preexisting Conditions: IBS Alopecia
Allergies: None
Diagnostic Lab Data: None yet. But March, I had a full panel of blood eidl done prior to starting hormone replacement therapy and my blood work showed I had a low white blood cell count.
CDC Split Type:

Write-up: 4/9/2021 10:30 am - Received vaccination 6:30 pm - Body Aches 7:30 pm - Chills and Shaking 8:00 pm - Fever from 96.9 to 98.9 9:00 pm - Fever from 98.9 to 100.1 10:00 pm - Severe Headache 11:00 pm - Fever from 100.1 to 101.50 4/10/2021 1:00 am - Fever from 101.50 to 102 2:00 am - Pains in my kidneys Throughout day, very lethargic and headache continued 8pm - Rash developed on neck and chest 4/11/2021 7:00 am - Rash moved further up my neck and pasty my shoulders 10:00 am - Called Pharmacy they recommend I go to Urgent Care or Hospital 12:00 pm - Checked in to Hospital and was treated for allergic reaction to immuzation


VAERS ID: 1203916 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Headache, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: Skin infection
Preexisting Conditions: No
Allergies: N/a
Diagnostic Lab Data: We have not seen a doctor regarding symptoms
CDC Split Type:

Write-up: Beginning at 4:00 pm she started having a severe headache, and stomach ach., within an hour she was vomiting. She vomited twice and was in severe pain with head ach. She also had body aches. By 4/10 in the am symptoms were still there but less severe. She has had a mild headache and some stomach pain and diarrhea since Sunday


VAERS ID: 1203933 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0141A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Not provided
Current Illness: Not provided
Preexisting Conditions: Not provided
Allergies: Naproxen, B-complex, acetaminophen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was vaccinated at 1630 and then proceeded to the monitoring area for her 30 minutes due to allergy hx. At 1700 pt started to c/o to monitoring RN that she felt tingling in her both her arms and legs. RN provided pt wit diphenhydramine 25mg PO with water. Pt continued to be monitored. No additional s/s of an allergic rxn were noted. Tingling improved and pt was discharged home with son at 1720.


VAERS ID: 1203947 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Dizziness, Feeling abnormal, Hyperhidrosis, Hypoacusis, Injection site pain, Presyncope, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Profuse sweating, light headed, hard to hear, almost fainted within minutes of receiving the shot. Was fanned, given orange juice and a cool towel. After 30 minutes I felt okay to leave the pharmacy. Felt lightheaded the rest of the day and really out of it. Developed a fever later that evening that ran throughout the night. Loss of appetite for 3-4 days. Diarrhea on day 4. Pain in arm at injection site for 4 days.


VAERS ID: 1203988 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0141A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Eye pruritus
SMQs:, Anaphylactic reaction (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: Plaquenil, Singulair, simvastatin
Current Illness:
Preexisting Conditions: Lupus, RA, IBS
Allergies: PCN, cogentin, compazine, dairy - lactose intolerant, trees
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received her vaccine at 1725 and proceeded to the monitoring area for her 30 minutes of monitoring. At 1755 pt c/o to RN of feeling itchy all over body. RN provided pt with diphenhydramine 25mg PO x 1 with water. No other c/o offered and pt''s symptoms improved after taking diphenhydramine. Pt feeling better and discharged home at 1825.


VAERS ID: 1204056 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pharyngeal paraesthesia
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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: Prozac, BCP, probiotics
Current Illness:
Preexisting Conditions: Chronic fatigue and cancer-related pain
Allergies: Shellfish, morphine, flonase; kiwi, blood
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated at 1750 and then proceeded to the monitoring area for her 30 minutes of monitoring. At 1820 pt c/o to RN of her throat feeling tingly. No other symptoms reported. RN provided pt with diphenydramine 25mg PO x 1 and water. RN continued to monitor the pt. Tingling improved and pt discharged home with her husband at 1830.


VAERS ID: 1204071 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

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

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

Write-up: I had chills the first night after the vaccine. In addition to that I have continuous pain in the legs, feeling of dizziness and fatigue even after sound sleep in the night. I am having feeling of nausea and vomiting on a continuous basis which have not gone away even after four days have been complete since vaccination.


VAERS ID: 1204114 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, 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: Junel FE 1.5/30 (28) 1.5 mg-30 mcg (21)/75 mg (7) tablet TAKE 1 TABLET BY MOUTH ONCE DAILY
Current Illness: n/a
Preexisting Conditions: vitamin D deficiency menorrhagia iron deficiency anemia
Allergies: Bexsero-frozen arm
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient reports she got the J&J vaccine Friday, had chills/fever/headache the next day. All side effects have resolved without treatment


VAERS ID: 1204135 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Nausea, Pain, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies: NO
Diagnostic Lab Data: PATIENT WENT TO ER ON 4/13, OUTCOME UNKNOWN
CDC Split Type:

Write-up: PATIENT STATES HE HAD COVID TWICE LAST YEAR AND THE VACCINE HAS BEEN WORSE. STARTING 2 HOURS AFTER VACCINATION HE HAD CHILLS, INTOLERABLE BODY ACHES, NAUSEA, VOMITING, FEVER. THEY LASTED 48 HOURS. BODY ACHES ARE STILL OCCURING 96 HOURS LATER. FEVER BROKE WITH TYLENOL. PATIENTS POA (HIS AUNT) CONCERNED ABOUT BLOOD CLOT.


VAERS ID: 1204142 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling cold, Headache, Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Mesalamine
Current Illness:
Preexisting Conditions:
Allergies: Penicillin augmentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/9/21 5:00 PM- back of head headache started, Took Tylenol. 6:00 PM worse headache ever had started vomiting. 7:00 PM headache and vomiting continued layed on bathroom floor could not get up cold and sweating. 11:00 PM made it to my bed and was freezing, shivering and sweating until approx. 8:00AM 4/10/21.


VAERS ID: 1204196 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure decreased, Dizziness, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Feels dizzy, syncopal episode, blood pressure drop, sweaty. BP monitor by paramedics and stay low, was transported to an area hospital emergency room or follow-up


VAERS ID: 1204214 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

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

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

Write-up: Sharp pain in leg below the knee for 3+ hours


VAERS ID: 1204217 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lethargy, Nausea, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin d, potassium, hctz, prozac, wellbutrin, pantoprazole, estrogen, metformin
Current Illness: none; hysterectomy 6 weeks prior
Preexisting Conditions: chf, GERD, anxiety/depression
Allergies: sulfa and chocolate
Diagnostic Lab Data: none
CDC Split Type:

Write-up: itching all over the body started about 7:15pm on 4/9/2021 and lasted until 4/11/2021 (took Benadryl and it helped ; Saturday 4/10 terrible lethargy (slept 20+ hours), Sunday 4/11 continued lethargy and new onset nausea and vomiting lasting until 4/12/2021 at 6:30pm


VAERS ID: 1204242 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: The evening after getting the vaccine I developed a severe headache, fever, and rigors. Headache resolved within 24 hrs after which I was able to rest and recover, while having a low grade fever and minor fever on day 2 (48hrs). Total recovery took 3 days. The reason for reporting is that this headache was unusually severe and prevented me from sleeping, delaying recovery.


VAERS ID: 1204243 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache, Muscle spasms, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal 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: Benadryl
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA. When I was going to bed, I had very bad chills, leg cramps, shortness of breath, and a pounding headache. my vision was a little blurry at times too.


VAERS ID: 1204260 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Chills, Headache, Hot flush, Hyperhidrosis, Nausea, Pyrexia, Somnolence
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 4:30pm hot flashes and chills begin 5:45pm sleepiness, fever, sweating, headache and abdominal pain begin 6pm nausea begins and laying down doesn''t help Unknown time between 6 and 7:45 Advil is taken 7:45 - 9:45pm sleep 9:45pm headache pain has centralized to one spot, no more nausea, still sweating with fever 11:30pm all symptoms except fever, nausea, and headache are gone. Remaining symptoms are less than they were. Day after vaccine fever, nausea, and headache persist but are decreased by Advil and drinking pedialyte and sports drinks with electrolytes. Day 3, only headache and fever occasionally return. No need for medicine, just taking constant electrolytes.


VAERS ID: 1204280 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Hypoaesthesia oral, Taste disorder
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Salty Taste at tongue and numbness around lips


VAERS ID: 1204296 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-19
Onset:2021-04-09
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Pain, Photosensitivity reaction, Tension
SMQs:, Systemic lupus erythematosus (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Excedrin for headache
Current Illness: none
Preexisting Conditions: history of headaches
Allergies: None known
Diagnostic Lab Data: none at this time. Pt does not have a PCP. Advised patient to seek medical attention at urgent care facility or ER to have headaches evaluated.
CDC Split Type:

Write-up: 04/09/2021 c/o mild headache, then 04/10/2021 severe headaches, sensitivity to light, slept with knit cap over eyes. Pt took Excedrin. 4:00 am and 9 am. Headache last until about 3pm on Saturday. Pt states "I did not feel right until Sunday afternoon, tired and sore from headache and tension." 04/13/2021 started with moderate headache around 3 am this morning, took Excedrin and the headache eased off.


VAERS ID: 1204313 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 - / -

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

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

Write-up: Patient was hospitalized and died within 60 days of receiving a COVID vaccine series


VAERS ID: 1204362 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0432A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Pruritus, Vital signs measurement, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered first dose of Johnson and Johnson vaccine. She actively carries an epi pen and was directed to self time for 30 minutes of observation. The paramedics were onsite and in charge of observation of the patients. At the end of the 30 minute observation period, she reported shortness of breath and an itchy back to the paramedics. No visible distress noted. At that time, the paramedics assisted her to the ambulance outside. Per paramedics" pt vital signs where stable and intacted, pt had mild inspiratory wheezes bilateraly in bases. pt had a hx of asthma and anxiety. pt was coached to control breathing pt felt better. pt transported at 1212 to The hospital. placed in bed and turned over care to facility rn without incident. all safety precautions taken."


VAERS ID: 1204463 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-27
Onset:2021-04-09
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1808978 / 1 - / SYR

Administered by: Private       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Head aches and slight nausea. Pain still in right shoulder where injection was given.


VAERS ID: 1204512 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Confusional state, Dizziness, Fatigue, Feeling abnormal, Fibrin D dimer, Glycosylated haemoglobin, Headache, International normalised ratio, Lipids, Metabolic function test, Prothrombin time, Pyrexia, Vitamin B12
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazepam 0.5 mg (PRN) Clobetasol 0.05% ointment Sodium-Potassium-Magnesium Sulfate Viibryd 20mg Rouvastatin 20mg
Current Illness: None
Preexisting Conditions: Anxiety & Depression Pure hypercholesterolemia Prediabetes
Allergies: Seasonal
Diagnostic Lab Data: Protime w/ INR, D-dimer, A1c, CMP, CBC, B12, Vitamin D, Lipid panel. Done 4/13/2021.
CDC Split Type:

Write-up: Brain fog, confusion, fever (101), headache, light headedness, fatigue, imbalanace.


VAERS ID: 1204539 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Tinnitus
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valsartan
Current Illness: Possible viral gastroenteritis week before vaccination
Preexisting Conditions: High blood pressure, discoid lupus
Allergies: Seasonal, pet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus in both ears beginning about 12-14 hours after vaccination. Still ongoing at the time of this submission.


VAERS ID: 1204548 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Cerebrovascular accident, Embolic stroke, Hemiparesis, Hypertensive crisis, Neurological symptom
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81mg once daily, Mature Multivitamin by Kirkland, D3 2000 IU once daily by Kirkland, Super B Complex by Nature Made, Hair Skin & Nails extra strength by Nature''s Bounty
Current Illness: Visit to Nurse Practitioner on 4/5 to flush ears for excessive ear wax
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: On 4/7/21 patient administered Janssen vaccine. On 4/8/21 at 7:00 am patient had stroke symptoms and advised to call 911 after conversation with AARP nurse hotline. Patient had difficult speaking and right side weakness. Transported via ambulance and admitted to hospital until discharge on 4/11 at 1:00 pm. Per patient diagnosis was Hypertensive Crisis, Acute Stroke with High suspicion for cardioembolic stroke.


VAERS ID: 1204600 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Disorientation, Dizziness, Fatigue, Feeling abnormal, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamsulosin. Glucosamine, Vitamin C, Vitamin D, magnesium, zinc, Microbe Formulas Comprehensive Protocol
Current Illness: None
Preexisting Conditions: MGUS, hyperlipidemia, lumbar spinal stenosis, chronic intermittent fatigue, nodular hyperplasia of prostate, history of lyme disease.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Beginning 4/9/21 (4 days after vaccination) woke up feeling fatigued and with some dizzy spells. Lasted till around noon then felt better. Started again around 4-5 PM. BPs elevated 189/92. Subjective feeling ?weird". Felt disoriented, tired, and dizzy. No fever. No dyspnea,. No headaches. At 7 PM BP was 165/86. 8pm was same. Following day 4/10/21 continued with symptoms of weakness and a little disoriented. Still weak and a little disoriented. Had medium grade headache at night. Next day 4/11/21 had fatigue all day and intermittent disorientation. Continued with medium grade top posterior headache. The headache resolved on its own without medication by later in morning. Blood pressure has been in the 135/73 range. No fever. Subjective improvement from 2 days prior. Next day 4/12/21 had profound fatigue. It began to let up by the evening. Next day 4/13 fatigue was not as severe but still present.


VAERS ID: 1204601 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-26
Onset:2021-04-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6956 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Full blood count, Immune thrombocytopenia, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine
Current Illness:
Preexisting Conditions: Chronic ITP. Low platelets. Counts have been fine for 12+ years. Two weeks after 1st dose Pfizer dose count dropped to 4,000.
Allergies:
Diagnostic Lab Data: CBC
CDC Split Type:

Write-up: I have chronic ITP but platelets have been fine for 12+ years. After first dose two weeks later my platelets dropped to 4,000 and had to be hospitalized


VAERS ID: 1204619 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

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

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

Write-up: Fever, chills, body aches, headache, muscle soreness at injection site, approximately 6 hours after vaccine was administered. Lasted about 15 hours.


VAERS ID: 1204707 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK RA / IM

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

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

Write-up: HA and fatigue


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