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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 99 out of 1,889

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VAERS ID: 1208293 (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: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

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

Write-up: Mainly Nausea with some vomiting for 1.5 days, body aches, chills, sore arm No treatment or doctor visits. Just slept


VAERS ID: 1208362 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Faecal vomiting, Headache, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Requip (restless legs). Xeljanj(stopped taking 2 days before and will not take for a week)Omeperarole,allergy medicine,pilocarpine(dry mouth
Current Illness: none
Preexisting Conditions: acid reflux, dry mouth, restless leg syndrome,rheumoid arthritis
Allergies: sulfa, cymbalta
Diagnostic Lab Data: none did call urgent care for advice
CDC Split Type:

Write-up: later in day extreme headache leg pain nauseous throwing up bile was on couch for 3 days headaches lasted for 2 and a half days throwing up 3 days leg pain first day third day extreme stomach and back pain. still 5 days later still have nausea slight headache and stomach pain


VAERS ID: 1208397 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 25mcg, Crestor 10mg, Omega 3 1 gram, lorazepam 1mg, metformin er 500mg, protonix 40mg
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: penicillin
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient reported that she had welts develop on her body one week after receiving the vaccine. She was going to take benadryl, report to v-safe, and report to her primary physician.


VAERS ID: 1208435 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: pt fainted


VAERS ID: 1208468 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Balance disorder, Blood test, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Computerised tomogram neck, Dizziness, Echocardiogram normal, Electrocardiogram normal, Fatigue, Headache, Hypertension, Hypoaesthesia, Injection site pain, Limb discomfort, Magnetic resonance imaging abnormal, Myalgia, Paraesthesia, Scan with contrast abnormal, Ultrasound Doppler, Ultrasound scan normal, Venogram abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: SYNTHROID
Current Illness: NONE
Preexisting Conditions: MTHFR
Allergies: NONE
Diagnostic Lab Data: ECHO-NORMAL 4/12, EKG-NORMAL 4/11, ULTRASOUND OF RIGHT LEG-NORMAL 4/11, CAROTID ULTRASOUND-NORMAL 4/12, BLOOD WORK, CT W/ CONTRAST OF HEAD&NECK-ABNORMAL4/11, MRI &MRV-ABNORMAL 4/12
CDC Split Type:

Write-up: DAY 1- two hours after vaccine my right arm and right leg felt restricted, numb and had some tingling in my hand, dull headche, muscle pain and dizziness. Day 2- mild pain at injection sight, muscle pain and general tirednes, dull headache,dizzy, right arm& left arm felt restricted and numbness in right pointer finger. Right leg felt restricted and pain behind the knee. Day 3- dizzy, dull headache, faint, high blood pressure, right arm & leg and left arm felt restricted and numbness/tingling in right hand. Pain behind right knee persisted. Went to ER Sunday early afternoon. Diagnosis is a cerebral venous thrombosis in sinus cavity. Still experiencing general weakness/tired, dizzy/unbalanced.


VAERS ID: 1208490 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Decreased appetite, Diarrhoea, Dizziness, Epistaxis, Fatigue, Headache, Influenza like illness, Menstrual disorder, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Depo-provera birth control shot, Zyrtec, Magnesium, Zinc, Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet. I see my doctor this afternoon.
CDC Split Type:

Write-up: The day I received the shot, I started to feel severe fatigue, headache, light-headed, and started running a fever about 6 hours after the shot was administered. The next day (4/6) was worse. Severe fatigue, muscle aches, headache, loss of appetite, fever (101.5 was the highest I notice but seemed to be around 101.1-101.3 all day), and general flu like symptoms. However, I also started experiencing abnormal menstrual bleeding. I am on the Depo shot and have been for some time. Due to this, I do not usually experience any menstrual bleeding so I found this to be a little odd. It was not heavy but it was noticeable and contained quite a few clots. Day 3 (4/7) was about the same except my fever came down and ranged from 99.8-101.1. Abnormal menstrual bleeding continued. New side effect this day included diarrhea. Day 4 (4/8) I started to see improvement. No fever (that I could tell). Remaining side effects included mild headache, fatigue, diarrhea, and abnormal menstrual bleeding. Day 5 (4/9), I had one of the worst nose bleeds I''ve ever had in my life. I apologize for the graphic description but it lasted about 20 minutes and my bathroom looked like a crime scene after. Blood was pouring out of my left nostril and I threw two large clots that were about the size of slug (or slightly larger than a fun size snickers... I wish I had a better way to describe it). I''ve had some bad nose bleeds, particularly when I was on Accutane, and this was worse! The rest of the day I felt like I was improving. Energy levels were better. No fever. Menstrual bleeding stopped. Only lingering side effect was mild headache and mild diarrhea. Since then I''ve continued to feel better and the diarrhea seems like it''s improving. Mild headache persists. Only new item is an annoying twitch in my left eye that started on Monday (4/12).


VAERS ID: 1208539 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry skin, Pruritus, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine 5 mg, enalapril 10 mg, levothyroxine 112 mcg, vitamin D, metamucil
Current Illness: none
Preexisting Conditions: Hx of previous breast cancer, hypertension and hypothyroidism
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pruritic rash over lower back. Red, dry, slightly raised 18 x 12 cm Micro-papular rash over upper abdomen, diffuse and subtle. The itching over lower back was intense for 3 nights but now seems to be subsiding on its own. No prescription medications were required. Patient was advised to use emollients and topical steroid or Benadryl prn if itching returned. Monitor clinically.


VAERS ID: 1208542 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Patient called the pharmacy on 4/14/2021 to report a throbbing in her left shoulder which radiates down to her elbow. This is the arm she received the vaccine in. The throbbing began on 4/9/2021 after receiving the vaccine on 4/7/2021. The pain has not resolved as of 4/14/2021. We advised her to consult her primary care physician.


VAERS ID: 1208549 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: After receiving J & J Covid vaccine, client stated she felt weak and dizzy. After sitting for a few minutes, assisted client to lie down on couch. Client was diaphoretic. BP 88/68. Legs elevated and given a few sips of juice. BP rechecked at 100/70. Client was well enough to transfer to observation area. Client waited another 15 minutes and left on her own with no further complaints.


VAERS ID: 1208571 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: urticaria


VAERS ID: 1208631 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: School       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling cold, Nausea, Night sweats, Pain, Pain in extremity, Piloerection
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: After about 7 hours of receiving the vaccine I started to shiver. My body felt extremely cold even though I was in 75 degree temperature indoors. I started getting goosebumps. That lasted for about 9 hours throughout the night. I also experienced nausea for about 30 minutes at 8:45 pm. I felt like I was going to pass out within that time period too. My head was also hurting throughout the night. My body was aching through the night as well. The only reason I am not sure if I had a fever is because I did not have a thermometer. My arm was sore for 3 days and I was also sweating throughout the first night.


VAERS ID: 1208639 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dysphonia, Fatigue, Oropharyngeal pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Unknown time-Flu-
Other Medications: Genivua, Farciegia, Clortmomeride, Trocevia, Decolicant, Crestor, prilia, Vit D.
Current Illness: no
Preexisting Conditions: Diabetes, IBS, Diverticilitis, High Cholesterol, Migranes, GERD
Allergies: Erythromycin, fish, nuts, metrotrexosate, all fruits, okra
Diagnostic Lab Data: COVID-19-neg
CDC Split Type: vsafe

Write-up: Later the day after the vaccine I developed severe chills and a really bad sore throat. I developed hives in my throat and mouth which cause hoarsness and was hurting really bad. On that Monday I visited my PCP who prescribed an antibiotic which did help and took antihistimines also. I developed a fever an was really tired and after about 3 day the symptoms subsided. My arm was really sore for about 2 days also.


VAERS ID: 1208671 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Injection site swelling, Myalgia, Night sweats, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, Chills, Night Sweats, Muscle aches, Fatigue, Swelling at vaccination site Lasted 48 hours


VAERS ID: 1208737 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chills, Heart rate increased, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Low Dose Aspirin, Vitamin C, D3, K2, Zinc, Calcium
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: Macrobid
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, chills, muscle aches, rapid heart rate, pain in rib cage, pain at injection site Lasted for about 48 hours


VAERS ID: 1208738 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Write-up: Headache, fever/chills, nausea. Lasted for about 13 hours


VAERS ID: 1208778 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-25
Onset:2021-04-09
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Has a history of malignant melanoma.
Preexisting Conditions: Malignant melanoma Chemo and immunnotherapy
Allergies: None
Diagnostic Lab Data: Patient had CTA chest that confirmed it.
CDC Split Type:

Write-up: patient has bilateral pulmonary embolism


VAERS ID: 1208781 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, 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: None
Current Illness: None
Preexisting Conditions: Sinus and allergies
Allergies: Penicillin, latex, pollen, dust, weeds, trees, crabgrass, mold, dog dander.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Shortness of breath followed by fatigue, chills, fever and entire body aches.


VAERS ID: 1208937 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: starting friday april 9th 2021, after patient recieved vaccination she has had a headache on the left side of her head. the headache has been continuous and is not relieved by pain medication


VAERS ID: 1208960 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Hyperacusis, Magnetic resonance imaging head, Migraine, Photophobia, Ultrasound scan, Varicose vein
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertaline (100 mg), Allergera for allergies, women multi-vitamin, B12 vitamin
Current Illness: none
Preexisting Conditions: Anxiety
Allergies: Baxtrum
Diagnostic Lab Data: On April 13, 2021, Emergency Room performed an ultra sound on left leg and found a blood clot. Hospital also performed an MRI on brain and brain vessels/sinus vessels and found no clot. On Covid-19 Vaccination Record Card, there is another number listed that may help assist: NDC 59676-580-15 Lot:1805020
CDC Split Type:

Write-up: Had Janssen shot on April 2, 2021. No issues whatsoever until April 9, 2021 when I began having a horrible blinding migraine. Sensitive to light and noise. No over counter headache medicine was helping. Same night, a painful blue line, (like varicose vein) formed in left calf. On Tuesday, April 13, 2021 went to Dr. office who agreed that these reactions are a concern and went to Hospital.


VAERS ID: 1208963 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort
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: Diclofenac sodium Topical gel 1%, Triamcinolone acetonide cream 1%, latanoprost solution .005%, pseudoephedrine hydrochloride, cetirizine, famotidine, Sam-e, St. John''s Wort, zinc, potassium
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Felt fine for hours while sitting at computer and then I got a feeling that I had never had before in my life. It felt as if there was an elephant sitting on my chest. No real pain. No panting. Just a real heavy chest. It is not heartburn or upset stomach - I know how that feels. It was uncomfortable and notice I got a look of distress in my face. That''s when I laid down on the couch with feet up and put my hands above my head towards the floor. After about 1.5 hours, the feeling went away. Haven''t had anything else since then.


VAERS ID: 1208989 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21H / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Eructation
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: mild abdominal pain starting one days after injection, then developed into stomach discomfort. On April 11-12 (4 days after injection), my stomach burped a lot.


VAERS ID: 1209014 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Diarrhoea, Pain, Pain in extremity
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Dehydration (narrow)

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

Write-up: Diarrhea, mild temperature, sore body initially. 3 days after pain in right leg. It feels like a sharp stabbing pain. Like a charley horse or dehydration. Drank water and Gatorade does not stop pain. Started to take 81 mg aspirin and did not stop pain. Just went to Dr. for blood test on 4/14/21.


VAERS ID: 1209030 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043 A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bradyphrenia, Chest X-ray, Chest pain, Chills, Dizziness, Dyspnoea, Headache, Heart rate increased, Hyperaesthesia, Hypoaesthesia, Nausea, Pain, Painful respiration, Sleep disorder, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (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: Vyvanse Escitalopram Propranolol Birth control pill Myocycline
Current Illness: None
Preexisting Conditions: ADHD Depression Anxiety PMDD
Allergies: None
Diagnostic Lab Data: Chest X Ray 04/10/2021
CDC Split Type:

Write-up: Started out with a headache and dizziness within a few minutes of the vaccine, along with nausea. I stayed put laying down with a lollipop and water bottle along with ice packs on me for about an hour until I was well enough they thought for me to drive back to my dorm. Once I started driving the headache was back but I was driving so I couldn?t do much. Almost pulled over because I was getting over whelmed but ended up making it back to my dorm. Once I got back I changed and laid down in bed hoping to fell better. Things started getting worse from there. Throughout the rest of the day my head ache and dizziness got worse to the point where I was pretty unsteady on my feet. Chills and body aches also started and progressed rapidly despite no fever. My nausea was present in waves but eventually dissipated around 8 PM. I tried to go to bed around 11 hoping to sleep off the symptoms. I began tossing and turning. My chills were really bad and it got to the point where my skin was so sensitive that the clothes I was wearing touching and rubbing against my skin were hurting me. I was so dizzy and light headed to the point where it didn?t matter if I was laying down or sitting up, I felt the same, extremely dizzy and lightheaded as if cotton were in my brain or as if it were working too slow. It was like trying to process thoughts through molasses. Then around 1:30 I couldn?t take it anymore and thought maybe a quick shower would help me to at least feel better so I could sleep. When I got in the shower I immediately knew things were worse. My vision started going black at the edges and black spots in the middle to the point where at certain moments I couldn?t see. I was fighting to stay on my feet and conscious and it was hurting to breathe. I knew I needed to get help so I stumbled to my dorm and collapsed when I got in the doorway to my room. My vision was spotty, my chest was hurting and I could barely breathe. My hands and feet went numb as well, I was shivering, and my body temperature was a little down to about 98.1 degrees Fahrenheit. I was transported to a hospital via ambulance my vitals were normal except elevated heart rate and O2 and was admitted at 2:40 in the morning. I received a chest x ray and my heart rate was better. The dizziness was under control by then. I was discharged at 4:50 in the morning.


VAERS ID: 1209136 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dyspnoea, Electrocardiogram, Intranasal paraesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ESCITALOPRAM, TRI-SPRINTEC
Current Illness:
Preexisting Conditions:
Allergies: CODEINE
Diagnostic Lab Data: RESULTS FAVORABLE PER PATIENT
CDC Split Type:

Write-up: TINGLING SENSATION IN BOTH ARMS UP TO SHOULDERS, TINGLING SENSATION IN NASAL SINUSES, LABORED BREATHING. HOSPITAL VISIT REQUIRED; LITER OF FLUID, 2 EKGS, BLOODWORK, CT SCAN. 5 HOURS VISIT AT HOSPITAL


VAERS ID: 1209148 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling hot, Hyperhidrosis, Malaise, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: needle phobias, has experienced fainting and feeling anxious and unwell from prior vaccines
Other Medications: NONE
Current Illness: NEEDLE PHOBIA, ANXIOUS
Preexisting Conditions: NONE KNOWN
Allergies: NONE
Diagnostic Lab Data: n/a
CDC Split Type: 1

Write-up: The patient had a needle phobia and was very anxious prior to the vaccine. Once the patient received the vaccine, he waited in the waiting area for 15 minutes post-vaccine. About 5 minutes after the vaccine, he notified the pharmacy staff that he wasn''t feeling well and he was feeling faint. The pharmacy staff provided him with a glass of water and was monitoring him. He said he felt like he fainted and wasn''t feeling well. He said he felt warm and sweaty. The pharmacy staff provided him with an ice pack. He then notified the pharmacy staff that he urinated in his chair while waiting post-vaccine. He wanted to be checked out and wanted us to call 911 . The patient began to feel better after about 20 minutes. The EMT arrived and checked the patient. Even though, the patient was feeling better, the EMT recommended the patient be checked further anyways. He was brought to the Triage center and was there for about 1 hour, according to the patient, and was feeling better. He said he felt slightly fatigued that day and the following day, but other than that he was feeling back to normal and no issues. He stated he has severe needle phobia and has experienced these fainting spells and anxiousness in the past. We followed up with the patient and he provided this information to us. He stated he was feeling good and back to normal. He had no further questions or concerns. We told him to follow up with us if questions or concerns came up.


VAERS ID: 1209167 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN042A21A / N/A LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea haemorrhagic, Haematochezia, Laboratory test normal, Rectal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLOPURINOL 300 MG Q DAY , HCTZ 25 MG Q DAY , AMLODIPINE 10 MG Q DAY , BUPROPION 300 MG XL Q DAY, HYDROXYZINE 25 MG QHS ,BUSPIRONE 15 MG TID , PRAZOSIN 2MG Q HS ,CLOTRIMAZOLE SOLN BID
Current Illness: NONE
Preexisting Conditions: GOUT , HTN , PTSD, OSA, OBESITY ,SUBCLINICAL HYPERTHYROID, ,KERATOCONUS
Allergies: NONE
Diagnostic Lab Data: WENT TO LOCAL ER REPORTS LABS NORMAL
CDC Split Type:

Write-up: TWO DAY AFTER VACCINE PATIENT HAD SEVERE LOWER ABDOMINAL CRAMPS AFTER AHVING MILK SHAKE AND ON 4/9/21 HE HAD RECTAL BLEEDING X 3 FIRST TIME BLOOD MIXED WITH STOOL ,SECOND TIME BLOODY DIARRHEA .THIRD TIME BLOOD


VAERS ID: 1209204 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache, fever for the first two days and chest pain, fatigue


VAERS ID: 1209210 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201AZ1A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Dizziness, Fatigue, Muscular weakness, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Fish Oil, Tramadol 50 mg
Current Illness: None
Preexisting Conditions: 5 herniated disk on my column
Allergies: Milk products Lactose and Cassein.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Nausea, Some Vomit, Stomach Upset, Stomachache, Mild but continuous Dizziness, Severe Fatigue, Muscle Weakness


VAERS ID: 1209217 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER872A / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood urine, Cerebral haemorrhage, Computerised tomogram head abnormal, Contusion, Epistaxis, Immunoglobulin therapy, Mouth haemorrhage, Platelet count decreased, Thrombosis, Tongue haemorrhage
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NIDDM, Hypothyroidism, Grade IV right temporal glioblastoma diagnosed in 2016 (received chemotherapy and radiation.)
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: 4/11/21 Platelets - 3,000.
CDC Split Type:

Write-up: 4/9/21-30 minutes to 1 hour after receiving 2nd dose of vaccine patient had bloody nose, clots, with bleeding sores on tongue and side of mouth. Began to have bruises on arms, feet and legs. Blood in urine and bruises on back. Presented to emergency department on 4/11/21. CT brain revealed a right sided posterior temporal hemorrhage. Patient was emergently treated with platelets, DDAVP, factor VII, Decadron, IVIG. 4/12/21, patient denies headache, changes in vision, double vision, change in sensation, including burning, pinprick, numbness, no focal or motor weakness. No change in bowel or bladder control. No sensory changes. Patient states she is now back to her normal state of health, save for the bruising described.


VAERS ID: 1209312 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Eye swelling, Headache, Muscle spasms
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cough syp Saline nasal spray Lipitor 10 ,g triamcinolone oint tylenol 325 mg Cetirizine 10 mg
Current Illness: none
Preexisting Conditions: Hyperlipidemia Allergic Rhinitis
Allergies: Tetracycline
Diagnostic Lab Data: Advised to call 911: declined opted to drive herself to Hospital
CDC Split Type:

Write-up: Severe Headache 10/10 started 1 day after injection Swelling and pain of 1 eye leg cramps


VAERS ID: 1209369 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Magnetic resonance imaging head normal, Migraine, Thrombosis, Ultrasound scan abnormal, Vein disorder
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Setraline 100mg daily, Zertek, women''s multi-vitamin
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: Baxtrum
Diagnostic Lab Data: Went to doctors office and Hospital on April 13, 2021 and emergency room performed an ultra sound on leg and found a blood clot. Emergency room also performed MRI of brain and sinus without any signs of blood clot.
CDC Split Type:

Write-up: On April 2, 2021 the Janssen shot was provided with no adverse events. On April 9, 2021, a sever migraine developed along with a blue line in left leg.


VAERS ID: 1209376 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest discomfort, Chills, Dyspnoea, Dysstasia, Gait disturbance, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: Xifaxan 550mg Ibuprofen 200mg
Current Illness: Chronic diarrhea of unknown origin, being treated with Xifaxan as possible SIBO
Preexisting Conditions: Chronic diarrhea Polycystic Ovary Syndrome
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day after receiving the vaccine, I experienced common side effects of fever, chills, body aches, and nausea, which lasted for 24 hours, and then I felt better. Then, 3 days after receiving the vaccine, I suddenly began to have extreme stomach pain, so bad that I could barely walk or stand up straight. My chest felt tight and I had shortness of breath. I thought about going to the ER, but called my GI specialist instead as I thought it could be related to the Xifaxan I was taking, but the office was already closed. The GI office called the following Monday and said the Xifaxan should not cause extreme stomach pain and to go to the ER if it persists, but by this time I was feeling much better. The severe pain lasted two days in total.


VAERS ID: 1209399 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: School       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: No
Preexisting Conditions: Asthma
Allergies: inhaler (not sure of name) reports hasn''t used inhaler in over a year
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient is 17 years old. EUA for Janssen vaccine is for 18 years and older and vaccine was administered to a patient who was under 18 years old


VAERS ID: 1209401 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women''s multi-vitamin, week off but Microgestin
Current Illness: None
Preexisting Conditions: None
Allergies: Non
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed a headache by the next morning after the shot. Within 27 hours I began to develop a fever, which went up to 104.5 at it''s peak - stayed there for about 8 hours, as well as severe chills and aches. The fever came down into 101 range around 11 pm, and woke up without a fever, but maintained some fatigue and light headache the following day. I took some Ibuprofen when I woke with the headache but did not take any more after the morning dose.


VAERS ID: 1209451 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Neck pain, Pain, Pain in jaw
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (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: Severe throbbing pain in center of chest, jaw pain and severe pain on right side of neck through the night starting about 12 hours after the injection.


VAERS ID: 1209504 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium + Vitamin E supplement; daily organic multi-vitamin
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Lidocaine (rash); erythromycin (nauseau); pineapple (food intolerance)
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the Janssen COVID-19 Vaccine EUA on Thursday morning. April 8, . Six hours later I had chills and a low grade fever for two hours. Then, thoughout the night, I experienced jaw pain making it difficult to sleep, but in the morning I applied ice and the pain went away. By Sunday, I felt 100% better.


VAERS ID: 1209580 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Axillary pain, Diarrhoea, Hypoaesthesia, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: none
Preexisting Conditions: none
Allergies: penicillan
Diagnostic Lab Data: none
CDC Split Type:

Write-up: - within the first 30-40 minutes: I could feel numbness creep up my arm on the side of the injection. It traveled as high as my eyebrow. It felt much like an injection would if you were getting a filling at the dentist. I couldn''t see any swelling or puffiness but definitely numb. This passed within the first few hours. - first two days - I was very sore and achy in my muscles all over my body, but on the third day it was centralized to just the muscles on my upper arm and under the arm kinda into the "peck" area I believe it would be called. - day 6 - today I have mild diarrhea and a slight upset stomach.


VAERS ID: 1209638 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol 25mg daily, clonidine 0.1mg daily, Depo-testostorone
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Physical examination
CDC Split Type:

Write-up: Facial paralysis/Bell''s Palsy


VAERS ID: 1209641 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Deep vein thrombosis, Dyspnoea, Fibrin D dimer increased, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pantoprazole, Pravastatin, Paroxetine
Current Illness: None
Preexisting Conditions: Chronic lymphocytic leukemia, History of prostate cancer--s/p prostatectomy, Hyperlipidemia, depression with anxiety
Allergies: None
Diagnostic Lab Data: D-dimer 9800 Lower extremity ultrasound positive for femoral vein DVT. CTA of chest- positive for bilateral lung pulmonary emboli in each lung lobe with left lower lobe infarction
CDC Split Type:

Write-up: patient was administered Moderna vaccine (initial shot) and within 48-72 hours became short of breath. He presented to my office for evaluation 4/14/2021 and found to have right leg DVT and massive bilateral pulmonary emboli with left lung infarction.


VAERS ID: 1209664 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Decreased appetite, Fatigue, Headache, Nausea, Peripheral swelling, Sluggishness
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

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: 65 mg iron
Current Illness: n/a
Preexisting Conditions: anemia
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: prolonged headache, ongoing fatigue, nausea, low appetite, sluggish. dull pain in lower abdomen. swelling in left leg.


VAERS ID: 1209680 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-01
Onset:2021-04-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multiple Vitamin, Cetirizine
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to hospital with positive covid diagnosis after 1 shot of moderna vaccine


VAERS ID: 1209700 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-03-08
Onset:2021-04-09
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Dyspnoea, Fibrin D dimer increased, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine, bisoprolol, Avalide, hydrocodone, pantoprazole, diclofenac gel, vitamin
Current Illness: none
Preexisting Conditions: hypertension, hyperlipidemia, coronary artery disease, GERD
Allergies: Augmentin, quinolones, benzalkonium
Diagnostic Lab Data: Elevated D-dimer (over 5) Multiple pulmonary emboli on chest CT
CDC Split Type:

Write-up: Dyspnea developed one day after vaccination. Symptoms have persisted until today, when she presented to office


VAERS ID: 1209760 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site swelling, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Leg pain, swelling under injection site remains several days after injection


VAERS ID: 1209781 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 585 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Dehydration, Feeling hot, Headache, Impaired work ability, Pain
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra, pantoporzole, keurvlo, one a day vitamin, iron, gas pill
Current Illness:
Preexisting Conditions: Seizures
Allergies: Epinephrine, Lamictal
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 6hrs after receiving the vaccine, I had to leave work due to the side effects of having extreme chills & being hott at the same time buy mostly chills, headaches, body aches all over, no energy, became dehydrated, no fever,


VAERS ID: 1209857 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Electrocardiogram, Laboratory test, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Xyzal Atenolol
Current Illness: None
Preexisting Conditions: POTS (Postural Orthostatic Tachycardia Syndrome
Allergies: Wellbutrin, Vicodin, Benadryl, Shellfish, Fish, Tree nuts, Peanuts, Sesame, Bananas
Diagnostic Lab Data: ER visit. Bloodwork, EKG, CT scan, chest X-ray 4-9-2021
CDC Split Type:

Write-up: Tachycardia of 115-178 bpm starting 6 hours after injection. Lasted 12 hours.


VAERS ID: 1209871 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JAN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, 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: -Aspirin 81mg -Complete Multivitamin Adult HealthKit (Berkley Jensen) -Vitamin C 1000mg
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Not known until now
Diagnostic Lab Data:
CDC Split Type:

Write-up: -Headache for 3 days, including the day of vaccination. -Numbness of upper extremities at night, but only on the third day of the vaccine (only once), no more has been presented.


VAERS ID: 1209879 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Echocardiogram
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)

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin
Current Illness:
Preexisting Conditions: heart disease
Allergies:
Diagnostic Lab Data: ct scan, bubble scan
CDC Split Type:

Write-up: stroke


VAERS ID: 1209887 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Lethargy, Nausea, Neck pain, Pain, Pain in extremity, Salivary hypersecretion
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: About 15 minutes after the injection I felt light headed and my chronic back pain was completely gone. Around 5 hours after injection I was overcome with extreme lethargy and had to sleep. 8 hours after injection I woke up very nauseous and could not stop salivating, however I never puked. I woke up again 18 hours after injection and felt nauseous and my chronic back pain had returned. I also had a weird throbbing pain in the right side of my neck and in the lower left side of my left leg. All symptoms were gone by ~36 hours after the injection.


VAERS ID: 1209913 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Unauthorized age group. Patient was administered vaccine and only 17 years old


VAERS ID: 1210051 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Crying, Dyspnoea, Fatigue, Headache, Mobility decreased, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan Hydrochlorothiazide 100/25
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin and sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: EXTREME reaction of fever, chills, body aches, fatigue, headache, & nausea. Completely bedridden for over 24 hours, crying, begging for life. For the following 72 hours: normal fatigue and nausea plus shortness of breath


VAERS ID: 1210057 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: PATIENT EXPERIENCED A LIGHT HEADACHE AFTER 3 DAYS OF VACCINATION ON 4/06/21. IT BECAME MORE SEVERSE AFTERWARD TILL TODAY (4/14/21) AND HAD A HARD TIME BREATHING. PHARMACIST ADVICED PATIENT TO GO TO EMERGENCY ROOM FOR TREATMENT.


VAERS ID: 1210083 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chest pain, Diarrhoea, Malaise, Nausea, Spinal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 60mg Lorazepam 2mg
Current Illness: None
Preexisting Conditions: ADHD, anxiety, depression, obesity
Allergies: Cipro
Diagnostic Lab Data: Haven?t sought medical treatment, thought this was all normal, maybe it?s not though
CDC Split Type:

Write-up: Sudden onset back pain on 04/09/2021, localized to the center of my spine, so bad i thought i was going to vomit. Tylenol was unhelpful but I had also taken my anxiety medication and 25mg of Benedryl, so the fact that it lasted roughly 4 hours is an estimation because i did eventually fall asleep. Chest pain on 04/10/2021, ongoing but only sometimes excruciatingly painful. Had costochondritis about a year ago, it eventually went away. This pain is the same as that. I was told that people who get costochondritis are likely to get it again, so may be unrelated to the vaccine, but thought i would list it anyways. General unwell feeling lasted until 04/13/2021 Unrelenting nausea lasted until 04/13/2021 Diarrhea started today 04/14/2021


VAERS ID: 1210096 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Heart rate increased, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hekla Lava, Magnesium, Vitamin D3, True Aloe, Calc. Fluoride, Aleve
Current Illness: No
Preexisting Conditions: Back pain, stenosis, Interstitial Cystitis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Tired for six days, fast heart beat one day, arm weakness in same arm of injection few days.


VAERS ID: 1210153 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3 Biotin Melatonin
Current Illness: Non
Preexisting Conditions: Non
Allergies: Non
Diagnostic Lab Data: I test positive at covid 19
CDC Split Type:

Write-up: I start with cough and temperature then all the symptoms of the COVID-19 for 3 days then i make appointment to test


VAERS ID: 1210294 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-19
Onset:2021-04-09
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Gait inability, X-ray
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: Only X-ray was done and seen the news and went to my doctors and he told me to report it to the website
CDC Split Type:

Write-up: It started from the chest and went abnormal serve pain couldn?t walked. Went to the emergency room and gave me pain.


VAERS ID: 1210361 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-03-10
Onset:2021-04-09
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Erythema, Oedema peripheral, Skin tightness, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin, aspirin, plavix
Current Illness: Yes, but unknown by this RN
Preexisting Conditions:
Allergies: Unknown
Diagnostic Lab Data: Pending results
CDC Split Type:

Write-up: Pt developed edema and pain to LLE from knee down to ankle on 4/9/21. Describes skin tightness and redness.. No fever, but with chills. Given crutches to avoid weightbearing on left leg. Pt is being worked up for potential blood clot, US Left venous duplex. Pending results for exams, Sent to emergency room on 4/13/21 by reporting nurse.


VAERS ID: 1210386 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Condition aggravated, Dyspnoea, Echocardiogram, Electrocardiogram, Pulmonary embolism, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Labetalol HCTZ
Current Illness:
Preexisting Conditions: Hypertension Prior DVT Prior Pulmonary Embolism (2005)
Allergies: Penicillin Cephalosporins
Diagnostic Lab Data: 4/9/21 Bloodwork, EKG, CT Scan at hospital 4/10-4/11 Echo and Ultrasound in both legs and hospitalization. Saw interventional cardiologist at hospital
CDC Split Type:

Write-up: Shortness of breath and chest pain 4/9/21 Went to ER on 4/9/21 Diagnosed with Multiple Pulmonary Embolisms in both lungs; transferred via ambulance as medical emergency to another hospital for treatment Released from hospital on 4/11/21 and currently under treatment


VAERS ID: 1210459 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: patient fainted, loss of hearing in ear, had a brief seizure


VAERS ID: 1210463 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-08
Onset:2021-04-09
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Feeling hot, Flatulence, Headache, Oedema, Paraesthesia, Vitreous floaters
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Retinal disorders (narrow), Vestibular disorders (broad)

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

Write-up: March 8th: After inj., floaters in eyes, slight dizziness, felt warm. Water given, observation by staff approx 30min. Nurse escorted me out of building for extra precautions. April 9th: Stomach cramping, headache left side. 400mg IBU taken. April 10th bi-lateral edema , lower legs, right sided headache. 400mg IBU taken and elevated legs. April 11th: slight stomach cramping returned, with excessive flatulence. April 12th: Tingling in lower legs, edema diminished.


VAERS ID: 1210471 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I was a baby, when I had my MMR vaccine half of my face swelled for an extended period of time
Other Medications: Lexapro (5mg daily)
Current Illness: No illnesses at time of vaccination or one month prior
Preexisting Conditions: I have Long Ganong Levine syndrome
Allergies: Codeine allergy
Diagnostic Lab Data: Monday April 12 I followed up with my primary care doctor and had an EKG and blood work all of which came back normal.
CDC Split Type:

Write-up: After receiving the vaccine I went and sat in a chair for the 15 minutes following the vaccine. Approximately 4-5 minutes later I started feeling really hot. Then I started getting nauseous and dizzy. I tried to get up and walk to the pharmacy desk (vaccine occurred at pharmacy) but fainted midway there. I was out less than one minute and after sitting down and having some water and putting ice packs on my face I felt better. I have never in my life fainted before. I wasn?t nervous or scared to have the vaccine. I followed up with my regular doctor on the Monday following the vaccine and had an EKG and bloodwork done all of which came back normal.


VAERS ID: 1210479 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Disturbance in attention, Dizziness, Feeling cold, Headache, Hot flush, Muscle spasms, Pain, Pelvic pain
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: excruciating headache for 13 hrs, cold chills for 2 days, hot flashes that made me feel like my insides were melting for 3 days, body aches; hips and pelvis area. As well as legs and feet cramping. Loss of concentration. Light headedness. No appetite for 2.5 days.


VAERS ID: 1210481 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoacusis, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hearing impairment (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: In order experienced: 1) muffling effects in ears 2) head ace 3) rash and ich on ears (both, worse on right) 4) sore spot across forehead, center/right 5) rash and ich on throat and neck (right side)


VAERS ID: 1210521 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: AFTER PATIENT RECEIVED THE DOSE OF COVID VACCINE JOHNSON AND JOHNSON HE WAITED FOR 15 MINUTES AND WHEN HE STOOD UP, HE COLLAPSED BUT HE WAS CONSCIOUS, WE HELPED HIM AND PUT HIM BACK ON A CHAIR AND HE PASSED OUT FOR 3 TO 5 SECONDS AFTER THAT HE STARTED FEELING BETTER BUT STILL VERY COLD AND PALE. WE ASKED HIM TO WAIT FOR OTHER 30 MINUTES AND AFTER THAT HE FELT OK.


VAERS ID: 1210562 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: No tests/doctor visit
CDC Split Type:

Write-up: Sudden onset of extreme chills, shivering uncontrollably until approximately 5am. This was accompanied by a severe headache and sore muscles. By about 10am the shivering/chills had subsided enough to be able to get out of bed and get Tylenol for the headache. This helped get some sleep. At about 1pm was the first time I checked my temperature and it read 102 orally. By this point the sore muscles had mostly subsided, but the headache and fever persisted until almost 11pm on the dot. The fever dropped from 102 to normal in under an hour.


VAERS ID: 1210603 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Chills, Dizziness, Immediate post-injection reaction, Injection site pain, Pain, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), 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: Suboxone 8mg strip, 1.5 strips per day Xanax 0.5 mg 3 x per day Tylenol 500 mg 2 pills 2-3 times per day Benadryl 25 mg, 4@bedtime Ibuprofen 200 mg 3-4 pills 1-2 times daily as needed for body pains
Current Illness: None
Preexisting Conditions: Obese
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Injection given very high on left shoulder. When injection started?burning pain went through the shoulder and then followed bloodflow down left arm to fingers, back up arm, down left side of back of neck, down the back, down the back of the left leg to foot, and back up to the middle of body before the burning no longer followed a path. Upon standing, I was dizzy, and told the pharmacist, and I told her that something felt wrong. She asked me to wait outside the pharmacy, standing, for 10 minutes. I was shivering and visibly shaking. Immediately after the injection, the burning on the left side persisted for over 30 min, and was over the whole left side of my body. I could not move my shoulder joint without a lot of pain. The pain has gotten worse each day, around the shoulder.....pain in the rest of my body has lessened.


VAERS ID: 1210626 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043AZ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility 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: PROPRANOLOL 10 MG BID FAMOTIDINE 20 MG QD
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: BEGAN MENSTRUAL CYCLE NINE DAYS EARLY


VAERS ID: 1210689 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-01
Onset:2021-04-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: johnson and jonson vaccine. He received on 4/1 through the state. that night got chills. ha, n/v. the next day just tired. 2 days later got two pink bumps on his R elbow then enlarged. then developed more on other areas on his body. some have been present in one spot for a week. NO sob or rep sx. no pain. He carries an epipen for insect allergy. on 4/9 he developed sensation of throuat closingand administred an epi pen with relief and went to er. At the er he was given iv prednisone, benedryl and pepcid. He was dischared on a medrol dose pack 7 day. taper (3 days left) and refilled epipen. told to take benedryl. no sob. rash is now stable, no new areas x 2 days, larger areas are much improved..


VAERS ID: 1210706 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Dyspnoea, Headache, Influenza like illness, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Flu like symptoms the day after vaccination. Including severe headache and bodyaches. The following symptoms started about four days after the vaccination? Severe headaches, shortness of breath, difficulty breathing, abdominal pain.


VAERS ID: 1210736 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (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: Accutane, lexapro, spironolactone, adderall, mono-linyah
Current Illness: Anxiety, ADHD, acne
Preexisting Conditions: Anxiety, ADHD, acne, depression
Allergies: Wellbutrin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscle and body aches began the evening I got the shot. At bed time I was shivering and woozy. I slept for many hours, until 5 pm the next day. Body/muscle aches and wooziness continued the next day but shivering was gone. Aches are still ongoing as of today (5 days after shot) but wooziness is gone. Aches are most prominent in the back. Did not take any medication to treat symptoms.


VAERS ID: 1210751 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenopia
SMQs:, Corneal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type: 041A21A

Write-up: Eye Muscle strain when moving eyes to look in any direction (up/down, left/right). No strain when looking straight. Lasted for roughly 4-5 days from day after injection, worst on first 3 days


VAERS ID: 1210755 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Diarrhoea, Influenza like illness, Influenza virus test, Nausea, Pyrexia, SARS-CoV-2 test, Sinusitis, Streptococcus test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen, norvasc, toprol xl, sertaline, adderall xr
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid, Strep and Flu swab
CDC Split Type:

Write-up: High fever, severe flu like symptoms, complete loss of taste and smell, being treated for severe sinusitis. Diarrhea, nausea. I have had covid before-these symptoms have been worse than when I had covid.


VAERS ID: 1210769 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-01
Onset:2021-04-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Heart rate increased, Injection site pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingrix, age 66
Other Medications: Levothyroxine 75 mcg, amlodipine 2.5 mg BID, lisinopril 10 mg, klor con 20 MEQ, daily multivitamin, vitamin d3 1000 mg, vitamin k2 45 mcg, curcumin 1000 mg,
Current Illness: N/A
Preexisting Conditions: Hypothyroidism, hypertension, cardiac svt, multiple myeloma
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness at site, tightness in chest, rapid heart rate, fever 99.5


VAERS ID: 1210807 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Chills, Fatigue, Injection site pain, Pain, Pyrexia, Sensitive skin, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline (50 mg), oral contraceptive, multi-vitamin, otc antihistamine
Current Illness: Seasonal allergies flared up causing congestion, post-nasal drip, and sore throat.
Preexisting Conditions: General anxiety disorder
Allergies: Seasonal (moderate reaction), insect venom (severe - EpiPen needed), raw broccoli (mild)
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8pm - Severe body aches began and skin sensitive to touch 10pm - Temperature begins to climb and chills start 12am - Tylenol taken 1am - Temperature reaches 103.1 3am - Temperature begins to decline Next day: extreme fatigue, chills continue, low grade fever (99.5-100.4), pain at injection site, and vomiting (3 episodes)


VAERS ID: 1210836 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-15
Onset:2021-04-09
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: B-cell lymphoma, Blood magnesium, Computerised tomogram head, Full blood count, Generalised tonic-clonic seizure, Metabolic function test
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Malignant lymphomas (narrow), Hypoglycaemia (broad), Haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac, vyvance
Current Illness: n/a
Preexisting Conditions: ADHD, anxiety, depression
Allergies: n/a
Diagnostic Lab Data: 4/9/21 - CT head - negative for acute pathology; CBC, BMP, mag WNL
CDC Split Type:

Write-up: pt with an new onset single episode of tonic-clonic seizure on 4/9 (3 weeks after vaccination) that lasted 60-90 seconds. patient with no predisposing trauma, no recreational or illicit drug use or alcohol use, no history of seizure disorder or family history of seizure disorder. pt with postictal state lasting 10-15 minutes. Patient went to ER following episode and treated with Ativan. Patient with no reports of seizure like activity or episodes since the event.


VAERS ID: 1210843 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast feeding, Breast pain, Chills, Lactation disorder, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Lipodystrophy (broad), Functional lactation disorders (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: Over the counter multivitamins
Current Illness: None
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I have a 9 month old daughter. I breastfeed her on a regular basis, every 4-5 hours. Twelve hours after receiving the vaccine along with the usual expected side effects -- fever and chills - I experienced a decrease in milk supply. My daughter was latched on the right breast and then on the left for a total of 15 minutes, there was no let down and no milk was flowing (I was intently listening and she was not swallowing which means no milk was coming out of either breast), let down usually happens after 2 minutes for me. The milk returned the following feeding, about 2 hours later although the let down took longer- about 10 minutes after she was latched on, and there was definitely less milk because my breasts were not full and at this point after 9 hours of no breastfeeding my breasts would have been very full and I would be experiencing some pain because of the fullness. My breastmilk supply is back to normal now.


VAERS ID: 1210865 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Electrocardiogram, Heart rate increased, Hypertension, Pain, Ultrasound abdomen, Ultrasound chest
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin, Bee stings
Diagnostic Lab Data: Bloodwork, EKG, Chest and abdomen ultrasound on April 9, 2021. Stress test and sleep apnea tests scheduled for April 15, 2021
CDC Split Type:

Write-up: Rapid heart beat, high blood pressure, chest pain, full body aches- ER visit for chest pain Nitro administered, chest ultrasound, blood work. Full body work up


VAERS ID: 1210880 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

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

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

Write-up: Fever began seven or eight hours after receiving the vaccine (evening). Did not take any medication; fever broke early morning the next day.


VAERS ID: 1211023 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Gaze palsy, Myalgia, Nasal congestion, Nausea, Sensitive skin
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Ocular motility disorders (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Headache: 4.5 days - current Nasal Congestion: 4.5 days - current Fatigue: 4 days Sensitive Skin: 2 days Nausea: 8 hours Muscle soreness: 1 day


VAERS ID: 1211047 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Janssen COVID-19 Vaccine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient is 6 months under age of 18 and shouldn''t have gotten the Janssen vaccine.


VAERS ID: 1211314 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood thyroid stimulating hormone, Dizziness, Electrocardiogram normal, Fatigue, Full blood count, Gaze palsy, Heart rate increased, Hyperhidrosis, Insomnia, Liver function test, Metabolic function test, Nausea, Palpitations, Troponin T, Urine analysis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: I was had my left arm and hand go numb after getting a flu vaccine. Another time my left jaw started to feel numb around 20 minu
Other Medications: Zyrtec ( taken the previous night), Melatonin ( previous night), Immodium, Nasonex No other medications taken within 24 hours of having the vaccine. Usual medications: Synthroid, Spironlactone , Mucinex, Nasonex, Melatonin, Nasonex, C
Current Illness: none
Preexisting Conditions: Hypothyroidism Sleep Apnea IBS High Cholesterol
Allergies: Penicillin, Doxycycline, Ciprofloxacin , Ceclor , Keflex, Bactrim, Ibuprofen, Aspirin, Entex, Hylan G-5 20 Injection, IV Contrast Dye, Percocet, Epinephrine, Pseudoephedrine , Adhesives, Sulfites, Sesame Seeds, Fluconazole, Fluticasone, Nitrofurantoin. Lidocaine Injection. Cortasteroid injection , allergic rhinitis
Diagnostic Lab Data: APRIL 9 EKG Basic Metabolic Panel CBC and differential LFT TSH Troponin T Urinalysis
CDC Split Type:

Write-up: Developed heart palpitations approximately 10 hours after receiving vaccine. Also insomnia making it impossible to sleep. Palpitations seemed to get better by 11 am the next morning but my heart rate was still elevated ( pulse 106-112). Shortly after that ( around 11:45 am) I became extremely light headed and dizzy and felt like I was going to pass out. I also started to feel nauseous and sweaty. I rested lying down for two hours before hearing back from my doctor''s office. I was able to control the lightheadedness and dizziness by lying down. The feeling of passing out / nearly fainting went away. I continued to feel nauseous and my heartrate was still elected. I started to get a headache as well. On the advise of a nurse at my doctor''s office, my husband took me to the ER. My EKG was normal . My heartrate was elevated. Due to the overcrowding at the ER that day I was made to wait at least an hour and half for further evaluation. I continued to feel light headed and slightly dizzy. My nausea and headache got much worse . I was finally taken back to a treatment room and received IV fluids, Zofran and Tylenol. My heartrate went back to normal and my headache and nausea improved with treatment and I was discharged around 7pm. I continued to feel very tired and slightly lightheaded that evening. The next morning I was much more nauseous again and still very weak feeling and slightly lightheaded. I have continued to feel weak, very fatigued , unwell and nauseous on and off until today, April 14, which is 6 days after I was vaccinated.


VAERS ID: 1211327 (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: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0211A21A / 1 LA / SYR

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

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

Write-up: I felt aching on my entire upper left arm all the way to shoulder. Had a minor fever midnight which make sleeping difficult. Fever stopped on 4/10/ 21 evening. Ache stopped on 4/12/21. I consumed 4 panadol pill in total, 2 on 4/9/21 midnight, 2 on 4/10/21 morning


VAERS ID: 1211360 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot - arm pain, slight fever, aches.
Other Medications: Benedryl
Current Illness: None
Preexisting Conditions: Allergies
Allergies: Celery, Avacado, Latex
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Body aches, chills, high fever (104), lasted appx 12 hours.


VAERS ID: 1211371 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Myocardial infarction, Pain
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: BP meds
Current Illness: high blood pressure on medications
Preexisting Conditions: high blood pressure
Allergies: Denies
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient had the vaccine and within 24-48 hours he began to experience pain on his right side-primarily abdomen area. He lives alone and is 86 years old. The pain got worse so he was taken to the hospital. He reports being told that he had a heart attack. He is still in the hospital at this time, but felt that he should report it. He does not know who is doctor is.


VAERS ID: 1210959 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-31
Onset:2021-04-09
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cystitis, Diarrhoea, Headache, Muscle spasms, Pyrexia, Urinary tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Fibromyalgia Migraines Chronic Fatigue
Allergies: None - allergic to cats, dogs, dust, mold, feathers, trees/grasses
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bladder/UTI infection, diarrhea, muscle spasms, fever, headache


VAERS ID: 1210960 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: levothyroxine rainbow lite prenatal vitamin fish oil Motherlove More Milk Moringa
Current Illness: hypothyroid
Preexisting Conditions: I''m currently breastfeeding my 8.5 month old baby.
Allergies: no
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: I woke up the day after my vaccine and felt very dizzy and fainted. (I had other symptoms that I would''ve expected after the covid shot as well... mild fever, chills, etc.)


VAERS ID: 1210970 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Fever, chills, sweats, headache, body aches, arm pain, extreme exhaustion


VAERS ID: 1210974 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dysphagia, Dysphonia, Dyspnoea, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Mast Cell Activation Syndrome (MCAS), Postural Orthostatic Tachycardia Syndrome (POTS), Dysautonomia, Ehlers Danlos Syndrome (EDS), Fibromyalgia, Gastroparesis, Chronic Migraines, Asthma
Allergies: Heparin, tropicamide, chlorhexidine, lidocaine, barium sulfate, cortisone injection, apples, pears, almonds, Brazil nuts, coconuts, honey, alcohol (liquor), smoke (tobacco, woodfire, marijuana), grass, trees
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hoarse voice, itchy throat, tight chest, trouble breathing, difficulty swallowing, throat closing (happened sequentially in that order)


VAERS ID: 1210979 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling, Pruritus, Pyrexia, Rash erythematous
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 75 MCG Levothyroxin
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever between 99 and 101 on second day. No fever on subsequent days. Swollen upper arm, red rash, pain in arm for the next 5 days. 6th day the swelling and pain dissipated. Still have the rash and some itching.


VAERS ID: 1211002 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Headache, Pain in extremity
SMQs:, Pseudomembranous colitis (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? Yes
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: Arm pain, headache, diarrhea, chills, and tiredness.


VAERS ID: 1211005 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

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

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

Write-up: janssen COVID-19 Vaccine EUA


VAERS ID: 1211157 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

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

Write-up: c/o persistent headache, n/ and dizziness since J&J vaccination on 9 Apr. denies chest pain, sob, v/d/, abd pain.


VAERS ID: 1211161 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-23
Onset:2021-04-09
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (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: Breastfeeding a child who was born on 1/4/21
Allergies: None
Diagnostic Lab Data: Appt on 4/12/21 confirmed shingles diagnosis
CDC Split Type:

Write-up: Developed shingles 2 1/2 weeks after first shot.


VAERS ID: 1211175 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adverse event, Arthralgia, Back pain, Dizziness, Headache, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Friday: sore arm, back ache, knee pain, dizziness Saturday: dizziness Sunday: rash on both legs Monday: headache Tuesday: all adverse events resolved


VAERS ID: 1211180 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye irritation
SMQs:, Corneal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: -----0-----
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: BURNING EYES APROXIMATELY 15 MINUTES AFTER VACCINATION - RESOLVED @07:55 ACCORDING TO PATIENT -NO BREATHING PROBLEM, NO RASH


VAERS ID: 1211191 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Lymphadenopathy, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: Previous COVID vaccine, dose 1 (EP7534); VAERS form #443036
Other Medications: Vitamin C, D, Calcium, Magnesium, Gingko Biloba, COQ10, Fish & Flaxseed oils, Gf thyroid remedy, Hair-Skin-Nails multi vitamin, Nutriobiotic Defense Plus & Grapefruit Seed extract, Quercetin w/bromelain, Olive leaf extract, MSM (methyl-sulf
Current Illness: none besides adverse effects of 1st dose of vaccine reported in VAERS form #443036
Preexisting Conditions: Migraines due to weather changes and hormones
Allergies: Gluten; mildly lactose intolerant
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2 days of mild soreness at injection site; swollen lymph nodes under jaw/sore throat and fatigue for 4 days after injection --everything was better after a week.


VAERS ID: 1211431 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness transient, Computerised tomogram, Dizziness, Electrocardiogram, Gaze palsy, Laboratory test, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: None known
Diagnostic Lab Data: 4/9/21 ER visit, checked blood sugar 2nd visit on 4/14/21 ct scan, ekg, blood tests
CDC Split Type:

Write-up: Unconscious, loss of sight temporarily. 6 days later, light headed, faint, severe headache


VAERS ID: 1211816 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-04-09
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Haemorrhage, Subdural haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Before vaccine no
Allergies: Pine trees
Diagnostic Lab Data: A lot.
CDC Split Type:

Write-up: Subdural Hematoma. Blood bleed


VAERS ID: 1211981 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Body temperature increased, Feeling hot
SMQs:, Neuroleptic malignant syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Started feeling warm and had aches in joints. Don''t think temperature went over 100. Stopped early Saturday afternoon (less than 24 hours).


VAERS ID: 1212001 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Acute stress disorder, Herpes zoster, Paraesthesia, Sensitive skin, Skin irritation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Opportunistic infections (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: levothyroxine
Current Illness: none
Preexisting Conditions: hashimoto''s thyroiditis
Allergies: none
Diagnostic Lab Data: 4/12/21 I was diagnosed with shingles
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA My skin (on top and going deeper) felt tingly, prickly, sensitive all over my abdomen. This began the day after the vaccine (4/9). By the afternoon of 4/12, it was feeling more intense. That''s when I realized I had a skin irritation on my lower back and stomach. I went to my doctor and it was diagnosed as shingles. My doctor said it was not caused by the vaccine but a stress reaction to the vaccine + normal stress in my life.


VAERS ID: 1212002 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Decreased appetite, Fatigue, Hypersomnia, Injection site erythema, Pain, Pain in extremity, Platelet count normal, Restless legs syndrome, Seizure like phenomena, Vomiting
SMQs:, Acute pancreatitis (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: flu vaccine
Other Medications: Yaz- birht control vitamin B12 vitamin D salt pills multivitamins one a day
Current Illness: POTS, MCAS, EDS, chronic fatigue, dysautonomia
Preexisting Conditions: POTS, MCAS, EDS, chronic fatigue, dysautonomia
Allergies: penicillin amoxicillin fentanyl Sudafed dilaudid
Diagnostic Lab Data: please contact the physician or hospital for details. We were not provided a list of blood work. We did ask about platelets and were told the level was "normal"
CDC Split Type:

Write-up: my daughter, 30 year old, on disability with POTS, MCAS, EDS, dysautonomia, received the JJ COVID vaccine at 1:30 PM on 4/9/2021.. She started vomiting 20 minutes after the vaccine was administered and the pharmacist said it was because she was anxious and has not eaten much. We went home, she was very tired and slept most of the afternoon. At 6 PM she started vomiting again. It continued till 10:30 PM when she could not drink anything. We went to the hospital where she exhibited what looked like a seizure in the waiting room and was admitted to the hospital for observation. Discharged 4/10/2021 evening. 4/11/2021 exhibited restless leg syndrome, could not sit, lay down, whole body aches. 4/12/2021 extremely sore arm, could not move it without pain. Area of injection looks read but not hot and no swelling.


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