|
| VAERS ID: |
1142350 (history) |
| Form: |
Version 2.0 |
| Age: |
17.0 |
| Sex: |
Female |
| Location: |
Indiana |
| Vaccinated: | 2021-03-23 |
| Onset: | 2021-03-23 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-03-28 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
- / 1 |
LA / - |
Administered by: Other Purchased by: ? Symptoms: Anaphylactic shock,
Tongue blistering,
Tongue pruritus SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: Zoloft hydroxizine Current Illness: none Preexisting Conditions: none Allergies: none Diagnostic Lab Data: CDC Split Type:
Write-up: blisters on the tongue, followed by itching, and anaphylactic shock from 11:30pm to 12:30am. benadryl and 2 epi pens were used and then at the hospital steroids and IV benadryl were utilized. Benadryl was used for the next 24 hours and then steroids were prescribed outpatient |
|
| VAERS ID: |
1181828 (history) |
| Form: |
Version 2.0 |
| Age: |
12.0 |
| Sex: |
Male |
| Location: |
Arkansas |
| Vaccinated: | 2021-04-02 |
| Onset: | 2021-04-04 |
| Days after vaccination: | 2 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-04-08 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
1805025 / 1 |
LA / IM |
Administered by: Other Purchased by: ? Symptoms: Swollen tongue SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: not know Current Illness: not known Preexisting Conditions: not known Allergies: not known Diagnostic Lab Data: N/A CDC Split Type:
Write-up: Patient was given vaccine at Community Outreach event on 04/2/21. Mother was contacted on 4/6/21 concerning incomplete name on her consent. She advised that her son received the covvid vaccine and had gone to the ER on 4/6/21 with a swollen tongue. She stated that he was treated with Tylenol and Benadryl and released to come home that day. Spoke with mom on 4/7/21 and she stated that the patient was stable and his entire tongue was not swollen just a small area. She denied any issues with his airway or breathing from time of vaccine to time of follow up call. |
|
| VAERS ID: |
1189473 (history) |
| Form: |
Version 2.0 |
| Age: |
12.0 |
| Sex: |
Unknown |
| Location: |
Arkansas |
| Vaccinated: | 0000-00-00 |
| Onset: | 2021-04-02 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-04-10 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
1805025 / UNK |
- / - |
Administered by: Other Purchased by: ? Symptoms: Off label use,
Product administered to patient of inappropriate age,
Swollen tongue SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Medication errors (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: Current Illness: Preexisting Conditions: Comments: Unknown Allergies: Diagnostic Lab Data: CDC Split Type: USJNJFOC20210411482
Write-up: SWELLING OF TONGUE; OFF LABEL USE; PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE; This spontaneous report received from a health care professional concerned a 12 year old of unspecified sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805025 expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-APR-2021, the subject experienced off label use. On 02-APR-2021, the subject experienced product administered to subject of inappropriate age. On 03-APR-2021, the subject experienced swelling of tongue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swelling of tongue, and the outcome of off label use and product administered to patient of inappropriate age was not reported. This report was non-serious. |
|
| VAERS ID: |
1300261 (history) |
| Form: |
Version 2.0 |
| Age: |
17.0 |
| Sex: |
Male |
| Location: |
Tennessee |
| Vaccinated: | 2021-04-08 |
| Onset: | 2021-04-08 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-05-08 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
041A21A / N/A |
RA / IM |
Administered by: Other Purchased by: ? Symptoms: Hypoaesthesia oral,
Lip swelling SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: unknown Current Illness: unknown Preexisting Conditions: unknown Allergies: unknown Diagnostic Lab Data: unknown CDC Split Type:
Write-up: C/O lips feeling big and numb after receiving Janssen vaccine. |
|
| VAERS ID: |
1575637 (history) |
| Form: |
Version 2.0 |
| Age: |
15.0 |
| Sex: |
Male |
| Location: |
Northern Mariana Islands |
| Vaccinated: | 2021-08-13 |
| Onset: | 2021-08-14 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-08-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
- / 2 |
- / IM |
Administered by: Private Purchased by: ? Symptoms: Chest discomfort,
Chest pain,
Electrocardiogram normal,
Painful respiration,
Pyrexia,
Troponin I increased SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
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: none Allergies: none Diagnostic Lab Data: An EKG was normal. DATE TIME SPECIMEN TEST VALUE Ref ranges ------------------------------------------------------------------------------- 08/15/2021 03:03 BLOOD TROP-I: 0.098 ng/mL .04 - 1.5 08/15/2021 00:42 BLOOD TROP-I: 0.139 ng/mL .04 - 1.5 CDC Split Type:
Write-up: Patient developed sudden onset fever, feeling of pressure on the chest, worse with inspiration, worse when laying down, better when standing up. The patient was given hyocyamine, famotidine, and tylenol and the fever and pain resolved. Three days later it has not recurred. |
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| VAERS ID: |
1588558 (history) |
| Form: |
Version 2.0 |
| Age: |
12.0 |
| Sex: |
Female |
| Location: |
Ohio |
| Vaccinated: | 2021-07-30 |
| Onset: | 2021-07-31 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-08-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
EW0217 / 2 |
LA / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Inappropriate schedule of product administration,
Rash SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Medication errors (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: Current Illness: Preexisting Conditions: Allergies: KNDA Diagnostic Lab Data: CDC Split Type:
Write-up: Patient received 2nd Covid Pfizer vaccine 14 days from the 1st vaccine. Father says patient had rash on waist/hip that resolved in around 7 days |
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Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=AGE&EVENTS=ON&SYMPTOMSSMQ=21&VAX=COVID19&VAXMAN=JANSSEN&WhichAge=range&LOWAGE=12&HIGHAGE=18