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This is VAERS ID 1703518

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First Appeared on 9/17/2021

VAERS ID: 1703518
VAERS Form:2
Age:64.0
Sex:Female
Location:Florida
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Breast pain, Fall, Fatigue, Herpes zoster, Hypertension, Nasopharyngitis, Neuralgia, Pain in extremity, Rhinorrhoea, Vomiting, Muscle strain, Blood pressure measurement, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE; ATORVASTATIN; ASPRIN; MONTELUKAST; ALBUTEROL [SALBUTAMOL]
Current Illness: Abstains from alcohol; Asthma; Cholesterol; Non-smoker; Thyroid disorder
Preexisting Conditions: Comments: The patient had allergy to Iron and charlie perfume and no abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: Blood pressure; Result Unstructured Data: 245/120; Test Date: 20210805; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC 'Split Type': USJNJFOC20210915462

Write-up: FALL; NERVE PAIN; ELEVATED BLOOD PRESSURE 245/120; SHINGLES INFECTION; PULLED MUSCLE, BUT WHEN IT STARTED GETTING WORSE AND WORSE, MUSCLE SPRAIN; VOMITING; RUNNY NOSE; COLD; SHARP PAIN AROUND SIDE AND UNDER BREAST ON LEFT SIDE; FELT VERY TIRED; SORE ARM; This spontaneous report received from a patient concerned a 64 year old female of unknown ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: asthma, thyroid, cholesterol, non alcohol user, and non smoker. The patient had allergy to Iron, charlie perfume and no abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: Unknown) dose was not reported, 1 total, administered on 12-APR-2021 to left arm for prophylactic vaccination. The patient indicated vaccination card was difficult to read and was not certain of lot number which was reported. The patient was reported batch number 180501 which was not match with any vaxchek records. The batch number was not reported and has been requested. Concomitant medications included montelukast and salbutamol for asthma, atorvastatin for cholesterol, levothyroxine for thyroid, and acetylsalicylic acid. On 12-APR-2021, the patient experienced sore arm began during vaccine administration and lasted for couple hours. On 25-JUL-2021, the patient experienced sharp pain around side and under breast on left side. The patient initially thought she a pulled muscle, but when it started getting worse and worse the patient went to emergency for assessment. During this emergency room (ER) visit there was no sign of rash at that time. The patient was provided pain medication, told she had a bad muscle sprain and to avoid work for a couple of days and was sent home from the emergency room. On unspecified date in JUL-2021, the patient said she felt very tired and about 48 hours after ER visit, big blisters appeared on back. The patient did not know the date the rash appeared but said it began about 5-7 days after pain developed. The patient said she contacted her family physician and notified doctor that she thought she had shingles and was told by her doctor not to come into office. The patient reports that 1 day or so after rash appeared (date unknown) she could not stand and fell down and an ambulance was called for assistance. The patient blood pressure was checked and reading 245/120. The patient indicated her usual pressure was 135/70. On unspecified date the patient was again taken to the ER. Once pain was treated and under control, the patient said her blood pressure dropped back to normal. The patient was diagnosed with shingles and provided pain medication baby Vicodin to control pain and stop vomiting. The patient was discharged on the same day. The patient also started taking Tylenol extra strength 2 tablets twice daily after ER visit and shingles diagnosis. The patient also said she applied Terassil over the counter (OTC) topical ointment, Asper cream and lots of ice packs to help with pain. On an unspecified date, patient experienced nerve pain. The patient reported a second fall which occurred 02-AUG-2021. The ambulance was called again, and the patient was taken to ER and admitted to hospital on 02-AUG-2021. The patient was again given Vicodin to control pain. The patient reports she spent 3 days in hospital and was discharged 05-AUG-2021. The patient reported she was doing better now but feel like hell. The patient also reports she might have picked up cold too and had a runny nose. The patient was concerned more likely to pick up illnesses now after vaccination. On 05-AUG-2021, the patient had a COVID-19 virus test when leaving hospital and had a negative result. The patient was taking prednisone 10mg daily, Gabapentin 300mg 6x/day after the shingles outbreak. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from elevated blood pressure 245/120, and sore arm on 12-APR-2021, was recovering from shingles infection, sharp pain around side and under breast on left side, nerve pain, and pulled muscle, but when it started getting worse and worse, muscle sprain, had not recovered from felt very tired, and runny nose, and the outcome of fall, vomiting and cold was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210915462-COVID-19 VACCINE AD26.COV2.S-shingles infection, nerve pain, Elevated blood pressure 245/120, Fall. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).

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