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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1272491



Case Details

VAERS ID: 1272491 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral normal, Bell's palsy, Chest X-ray normal, Chest discomfort, Chills, Computerised tomogram head normal, Diarrhoea, Dyspnoea, Facial paresis, Fibrin D dimer increased, Headache, Hypoaesthesia, Magnetic resonance imaging head normal, Nausea, Pain, Palpitations, Pituitary scan, Pregnancy test negative, Pyrexia, Sleep disorder, Throat tightness, Ultrasound Doppler, Venogram normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (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 meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sulfa antibiotics
Diagnostic Lab Data: CT Brain normal, MRI Brain normal, and MRV Brain with no evidence of venous sinus thrombosis, carotid doppler normal, MRA Brain normal, MRI sella (pituitary) normal)
CDC Split Type:

Write-up: Patient is a 40 y.o. female who presents for evaluation of adverse reaction to Johnson and Johnson COVID vaccine (received on 4/11/21). She received the vaccine on April 11th, around 2:30 p.m. at 8:00 p.m. that night she developed fever with temp 100.4?, chills, headache, nausea and body aches. At 10:00 p.m. that night she developed palpitations, heart racing, shortness of breath, tightness in her throat and chest. She was unable to sleep that night. The next day on April 12th, she continued to have low-grade fever with temp 99?, shortness of breath, chest tightness. She reports taking a pregnancy test at home which revealed a faint positive pink line. That night she took Tylenol which helped relieve some of her symptoms. On April 13th, she continued to have shortness of breath and chest tightness, her heart palpitations improved slightly. She reports retaking the home pregnancy test and this time it was negative. On April 14th, she had a same-day clinic visit, labs that day revealed slightly elevated D-dimer and normal chest x-ray. She continued to have shortness of breath and on April 16th, she presented to the ER due to sudden onset of bad headache, nausea, diarrhea and heart palpitations. She was discharged from the ER with close follow-up with her primary care doctor. Her symptoms did not improve and subsequently on April 20th, she began to have left-sided facial numbness. On April 21st, she went to the ER and was found to have left-sided facial weakness and suspected Bell''s palsy. She was admitted for further diagnostic workup (CT Brain normal, MRI Brain normal, and MRV Brain with no evidence of venous sinus thrombosis, carotid doppler normal, MRA Brain normal, MRI sella (pituitary) normal), and treatment was initiated with prednisone and antiviral medications. On April 23rd she developed left arm weakness as well. She was discharged with closed follow up with her PMD and specialists. She recently was seen by pulm Dr and scheduled for PFTs. She is nearly completed with course of prednisone and valacyclovir, left facial weakness slightly improved but not resolved, has follow up with neuro this week.


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