VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1236104
Sex: F
Age:
State: OH

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: SPASMS ON LEGS, ARMS AND HEAD; SLIGHT HEADACHE; EXTREME TIREDNESS; SLIGHT FEVER; NAUSEA; BODY ACHES; PROFUSE SWEATING; POSSIBLE SEIZURE; This spontaneous report received from a consumer concerned an 18 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included food allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: unknown) dose was not reported, 1 total administered on 11-APR-2021 around 11:30 to left arm for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, after vaccination patient had done lower body workout. On 11-APR-2021, the patient experienced nausea, extreme tiredness, slight fever, slight headache, body aches, and profuse sweating by evening. She took some children's liquid paracetamol (Tylenol). On 12-APR-2021 about 02:00, she also had spasms of her arms, legs, and head that lasted about 20 minutes. She took paracetamol (Tylenol) at about 03:00 and was pretty out of it. The patient's mother was concerned that it could had been a seizure (possible seizure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from spasms on legs, arms and head on 12-APR-2021, and the outcome of nausea, extreme tiredness, slight fever, slight headache, body aches, profuse sweating and possible seizure was not reported. This report was serious (Other Medically Important Condition).; Sender's Comments: V0:20210423951-Covid-19 vaccine ad26.cov2.s-seizure. This event is considered unassessable. The event 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.

Other Meds:

Current Illness: Food allergy

ID: 1236105
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 04/03/2021
Rec V Date: 04/21/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: BLACKED OUT; VERTIGO AGGRAVATED; BROKEN NOSE; FALL; BUSTED LIPS; COULD NOT EAT ANYTHING; CHILLS; FEVER; This spontaneous report received from a patient concerned a 33 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included vertigo, non-alcohol user, and non-smoker. The patient was not pregnant at the time of reporting. The patient had no known drug allergies and no history of drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: 21-JUN-2021) dose was not reported, 1 total, administered on right arm on 03-APR-2021 13:30 for prophylactic vaccination. Concomitant medications included meclozine hydrochloride for vertigo. On 03-APR-2021, 15 minutes after vaccination the patient felt dizzy. On the same evening, the patient experienced fever, vomiting, sweating, dizziness and chills. On 04-APR-2021, the patient could not eat anything and experienced black out and fell from which the patient experienced busted lips and broken nose. The patient was taken to the emergency room and was hospitalized on 04-APR-2021. During hospitalization the patient had blood test and chest X-ray which was normal and COVID-19 virus test was negative. At the hospital the patient was diagnosed with aggravated vertigo due to vaccination but according to the patient it was not her vertigo since she did not get her usual vertigo symptoms before blacking out (dizziness, room spinning, or feeling like about to fall). The duration of hospitalization was 1 day. On 07-APR-2021, the patient went back to the hospital to follow-up and the patient's physician ran tests for blood work and computed tomography (CT) scan of her head with no abnormal findings. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the blacked out, vertigo aggravated, broken nose, fall, busted lips, could not eat anything, chills and fever was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender's Comments: V0: 20210423964-covid-19 vaccine ad26.cov2.s -Vertigo aggravated. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY VO:20210423964-covid-19 vaccine ad26.cov2.s-broken nose, black out. 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).

Other Meds: MECLIZINE HYDROCHLORIDE

Current Illness: Abstains from alcohol; Non-smoker; Vertigo

ID: 1236106
Sex: F
Age:
State: SC

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: BLURRY VISION; RINGING IN BOTH EARS START IN ONE AND SWITCHES TO OTHER EAR; This spontaneous report received from a patient via a company representative concerned a 59 year old female. 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: 1802072, and expiry: UNKNOWN) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced blurry vision, and ringing in both ears start in one and switches to other ear. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from blurry vision, and ringing in both ears start in one and switches to other ear. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236107
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 100 DEGREE FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and 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: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced 100 degree fever. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 100 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of 100 degree fever was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236108
Sex: M
Age:
State: NY

Vax Date:
Onset Date: 04/11/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: FEVER; MUSCLE PAIN; This spontaneous report received from a patient concerned a 26 year old male. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, expiry: UNKNWON) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced fever. On 11-APR-2021, the subject experienced muscle pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and muscle pain. This report was non-serious.; Sender's Comments: V0:Medical assessment comment not required as per standard operating procedures.

Other Meds:

Current Illness:

ID: 1236109
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 04/12/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: HEADACHE; INJECTION SITE PAIN; EXTREME FATIGUE; This spontaneous report received from a patient concerned a 57 year old female. The patient's weight was 150 pounds, and height was 63 inches. The patient's concurrent conditions included psoriatic arthritis, occasional alcohol use, and non smoker, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting and had no known drug allergies. The patient had no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 205A21A, and expiry: 23/JUN/2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. Concomitant medications included folic acid, methotrexate, and tofacitinib citrate. On 12-APR-2021, the subject experienced extreme fatigue. On 12-APR-2021, the subject experienced injection site pain. On 13-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from injection site pain, and had not recovered from extreme fatigue, and headache. This report was non-serious.

Other Meds: XELJANZ; METHOTREXATE; FOLIC ACID

Current Illness: Alcohol use (Social drinker at events or occasionally at meals.); Non-smoker; Psoriatic arthritis

ID: 1236110
Sex: M
Age:
State: IN

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: ARM PAIN; MIGRAINE; TROUBLE SLEEPING; This spontaneous report received from a patient concerned a 37 year old male. 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: Unknown) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced migraine, trouble sleeping, and pain in arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the migraine, trouble sleeping and pain in arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236111
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: ARM SORENESS AT INJECTION SITE; HEADACHE; FEVER THAT SLOWLY ROSE/6 HOURS AFTER FEVER REACHED 101.3/ FINALLY 28 HOURS AFTER TEMP WENT DOWN TO NORMAL; This spontaneous report received from a consumer concerned a female of unspecified age. 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: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot number. No concomitant medications were reported. On an unspecified date, the subject experienced arm soreness at injection site, headache, and fever that slowly rose/6 hours after fever reached 101.3/ finally 28 hours after temp went down to normal. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 101.3 F The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever that slowly rose/6 hours after fever reached 101.3/ finally 28 hours after temp went down to normal, had not recovered from headache, and the outcome of arm soreness at injection site was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236112
Sex: M
Age:
State: IL

Vax Date:
Onset Date: 04/11/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: LUMP UNDER THE JAW; ITCHY; PAIN; SORE ARM; This spontaneous report received from a patient concerned a male of unspecified age. 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 and batch number: 180A9A0 expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the patient experienced lump under the jaw. On 11-APR-2021, the patient experienced itchy. On 11-APR-2021, the patient experienced pain. On 11-APR-2021, the patient experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from lump under the jaw, sore arm, itchy, and pain. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236113
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: RIGHT EYE CLEAR LIQUID SECRETION; RIGHT EYE WAS SWOLLEN SHUT; ARM SORENESS; REDNESS OF FACE; SWEATING; This spontaneous report received from a patient concerned a 45 year old female. 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 and batch number: 202A21A expiry: 23-JUN-2021) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced redness of face. On 10-APR-2021, the subject experienced sweating. On 10-APR-2021, the subject experienced arm soreness. On 12-APR-2021, the subject experienced right eye clear liquid secretion. On 12-APR-2021, the subject experienced right eye was swollen shut. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from right eye clear liquid secretion, and right eye was swollen shut on 12-APR-2021, and redness of face, and sweating on 11-APR-2021, and was recovering from arm soreness. This report was non-serious.; Sender's Comments: V0: Medical assessment comments not required as per standard procedure as the case is considered non serious.

Other Meds:

Current Illness:

ID: 1236114
Sex: F
Age: 67
State: GA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Contrast Dye, penicillin, ampicillin

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Anaphylaxis or anaphylactic shock Treatment: Epinephrine, Benadryl and steroids

Other Meds: B12, D3, Cod liver Oil

Current Illness: none

ID: 1236115
Sex: F
Age: 62
State: CA

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Only reaction is to generic Vicodin (extreme nausea) and a very old drug - Declomycin taken when I was about 8 yrs old - developed a rash.

Symptom List: Rash, Urticaria

Symptoms: Frontal lobe headache to start within a few hrs of vaccine. Back of the head to lower neck headache 8 hrs after. Every tooth in my mouth started throbbing at around 11 hrs and continued for about 5 more hours. Also during that time, waves of nausea but no vomiting, also uncontrollable shivering but I wasn't cold and I wasn't hot but weird shivering. I did not take my temperature as I didn't feel like I had a fever. Around 13 hrs after a stabbing pain in front of thighs like hot pokers started and around 14 hrs thigh pain was still present but then the calves on both legs started to get the same stabbing pain. At around 24 hrs after - headache remained, pulsating teeth stopped, thigh pain stopped but calf pain remained. Headache remained off and on for several days. General brain fog also lasted for about 1 week. The calf pain comes and goes even after 2 weeks. Arm where shot was administered was very tender to the touch for the last 2 weeks. Lastly, I wouldn't say I had shortness of breath but at times I just felt like I needed to stop and force myself to take a very deep breath.

Other Meds: no RXs, no OTC, only vitamins - C, D3, CQ10, A, D, K, B Complex, Magnesium, Zinc

Current Illness: No illnesses at the time nor up to one month prior - no illnesses over 2 years.

ID: 1236116
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: IN ICU WITH CLOTS; This spontaneous report was received from social media via a company representative and concerned a male patient of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose, start therapy date were not reported, for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the patient was hospitalized in the intensive care unit (ICU) with clots (date unspecified). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome for the event of clots was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender's Comments: v0 This report involves a male patient of unspecified age who received the Janssen COVID-19 Vaccine Ad26.COV2 and, after an unspecified period of time, was hospitalized in the intensive care unit (ICU) with "clots" (site unspecified). Medical history, concomitant medications, and details of the event were not reported. This case has insufficient information to make a meaningful medical assessment. The case will be assessed further when additional information is received.

Other Meds:

Current Illness:

ID: 1236117
Sex: F
Age: 47
State: FL

Vax Date: 03/07/2021
Onset Date: 03/27/2021
Rec V Date: 04/21/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: n/a

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Immediately had flu symptoms the same night as vaccine that went away within 2 days. HOWEVER, twenty-one (21) days later, both eyes were extremely painful to move. Then I lost vision in right eye with extreme blurriness & partial blind spots resulting in a diagnosis of Optic Neuritis by Ophthalmologist and Neurologist. Confirmed optic Neuritis on MRI scan. Twenty-four (24) days later, numbness in legs, feet and right arm started. Hard to walk up and down stairs. Twenty-six (26) days later, extreme pain in in muscles and skin along with tingles all over and numbness. Weakness and Chest pain. Flu like symptoms without fever ie: aches, pains, skin pain, confusion. Dizziness, feeling of being extremely anxious and out of sorts in space. Had to complete round of Steroids and numbness and tingles got better, but did not dissolve. After completion of IV steroids, thirty-four (34) days later all symptoms returned full force and worsening. Checked into ER 4/10 and admitted into hospital. Have not been able to complete normal routine or work level since March 27th due to neurological disturbance and symptoms. Two (2) Eye exams, 3/30/21 confirming swollen optic nerves. MRI 3/31/21 Blood work 4/2/21 CoVid Test 4/9/21 Negative Hospital: April 10-12th. MRI Extensive Blood work Spinal Tap Neuro-Opt exam Outcome pending and further treatment pending results.

Other Meds: Zyrtec

Current Illness: n/a

ID: 1236118
Sex: F
Age: 23
State: CA

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin Pollen Dust

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: After the vaccine, the whole body has been allergic and itchy, and the skin will appear red rash when scratching.

Other Meds: No

Current Illness: No

ID: 1236119
Sex: F
Age: 25
State:

Vax Date: 04/09/2021
Onset Date: 04/20/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: 25 yo G2P0 @ 37+1 pregnant with longstanding immune thrombocytopenia purpura with a routine CBC showing PLTs of 56 down from 119 1 month ago. Had J&J vaccine on 4/9. - Lab repeated and confirmed - D/w MFM and Hematologist. In an abundance of caution, will get coags, CMP, and P/cr urine ratio to evaluate for HELLP. Will also get HIT antibodies to evaluate for possibility of Vaccine induced thrombocytopenia(VIT). - Will plan on treating with Dexamethasone 40mg Daily x 4 days to increase platelet count. D/w hematologist, and he will see the patient and run the test for HIT antibodies (PF-4) and initiate IVIG treatment, which would help treat the low platelets either from exacerbation of ITP or VIT. If these come back positive, will likely transfer patient to HN for admission and delivery to be followed by therapeutic anticoagulation with non-heparin based therapy, consistent with usual therapy for HIT.

Other Meds: Prenatal vitamins

Current Illness: Immune thrombocytopenia purpura, pregnancy

ID: 1236120
Sex: F
Age: 41
State: FL

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: penecillin

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Client c/o tingling and numbness of L arm. Client seen by EMT (no v/s taken). Client observed to be stable, no distress noted at the moment. Client cleared to go home by EMT.

Other Meds: none

Current Illness: none

ID: 1236121
Sex: M
Age: 52
State: VA

Vax Date: 04/15/2021
Onset Date: 04/17/2021
Rec V Date: 04/21/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I HAVE A LOSS OF MY CENTRAL VISION IN MY RIGHT EYE DUE TO A BLOCKAGE IN MY RETINAL ARTERY (BRANCH RETINAL ARTERY OCCLUSION).

Other Meds: none

Current Illness: none

ID: 1236123
Sex: F
Age: 35
State: AZ

Vax Date: 03/25/2021
Onset Date: 03/27/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Cipro

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I started with a fever, chills and just general flu like symptoms that started the day of my 2nd vaccination(3/25/21) all which I knew I may experience. These started around 9pm on Thursday evening, and subsided by 6pm on Friday 3/26/21. On Saturday 3/27/21 I started to feel pain in my lower back. It wasn?t pain in the muscles it was itching of the skin that turned into a piercing pain that covered my lower back. I contacted my primary care and she said it sounded like shingles and asked if I had a rash. I did not. She started me on Gabapentin 300mg 1 capsule by mouth 3x a day as needed for pain. The symptoms lasted until approximately the evening of Tuesday 3/30/21. No rash ever appeared but the burning/itching/piercing pain is what stayed with me for those 3 days.

Other Meds: None at the time of vaccination

Current Illness: None

ID: 1236124
Sex: F
Age: 32
State: MA

Vax Date: 03/23/2021
Onset Date: 04/17/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: 4 days of right upper extremity pain and swelling with diagnosis of right upper extremity axillary vein DVT that was treated with DOAC apixaban.

Other Meds:

Current Illness:

ID: 1236125
Sex: F
Age: 32
State: TX

Vax Date: 04/07/2021
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin, mushrooms, cashews, cow?s milk, fennel, banana, and mold.

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: One day after shot: body aches, pain In both legs. Three days after shot: pain in shoulder and upper chest, particularly when inhaling Five days after shot: loss of voice, sharp shooting/crushing pain in left chest cavity, increased pain when breathing Six days after shot: diagnosed with Pulmonary embolisms in left lung, pleurisy, and inflamed lymph nodes near left lung.

Other Meds: Nuvaring, lexipro, xyzal, melatonin, b6, calcium, vitamin c, ashwaghanda, zinc, pre & probiotic, vitamin D3.

Current Illness: None.

ID: 1236126
Sex: F
Age:
State: MN

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: LIKE SOMETHING CRAWLING IN BLOOD; NAUSEA; MUSCLES ACHES; INJECTION SITE PAIN (IN LEFT ARM); SWELLING OF THE ARM; BURNING SENSATION IN THE LEFT ARM; ACHES AND PAINS; This spontaneous report received from a patient concerned a 55 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included high blood pressure, and venous insufficiency, and other pre-existing medical conditions included patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced aches and pains. On 09-APR-2021, the subject experienced swelling of the arm. On 09-APR-2021, the subject experienced burning sensation in the left arm. On 09-APR-2021, the subject experienced injection site pain (in left arm). On 10-APR-2021, the subject experienced like something crawling in blood. On 10-APR-2021, the subject experienced nausea. On 10-APR-2021, the subject experienced muscles aches. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from like something crawling in blood, nausea on 12-APR-2021, and muscles aches on 11-APR-2021, had not recovered from injection site pain (in left arm), and the outcome of swelling of the arm, burning sensation in the left arm and aches and pains was not reported. This report was non-serious.; Sender's Comments: Medical assessment comment not required as per standard procedure as case was assessed as non-serious.

Other Meds:

Current Illness: Blood pressure high; Venous insufficiency

ID: 1236127
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: BLOOD CLOTS IN MY LEFT LUNG; GOT SERIOUSLY SICK; This spontaneous report received from a patient via a company representative and concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received Janssen COVID-19 Vaccine (ad26.cov2.s) (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 20-MAR-2021 for prophylactic vaccination. The batch number was not reported, and has been requested. No concomitant medications were reported. On an unspecified date, the patient got seriously sick and was hospitalized for blood clots in left lung on unspecified date. Patient reported blood clots in left lung that caused to be hospitalized for two days. Patient reported being on blood thinners (unspecified) and oxygen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the got seriously sick and blood clots in my left lung was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender's Comments: V0: A patient of unspecified age and sex experienced blood clots in the left lung an unspecified time after vaccine. The patient reported being on blood thinners and oxygen. No further details were provided. There is insufficient information to make a meaningful medical assessment. Additional information has been requested.

Other Meds:

Current Illness:

ID: 1236128
Sex: M
Age:
State:

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: FAINTED; This spontaneous report received from a consumer concerned a male of unspecified age. 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) dose was not reported, administered on 17-MAR-2021 for prophylactic vaccination. The batch number was not reported. We are unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date in MAR-2021, the patient fainted approximately after 35 hours of being vaccinated. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fainted on MAR-2021. This report was serious (Other Medically Important Condition).; Sender's Comments: V0:covid-19 vaccine ad26.cov2.s-fainted. This event is considered unassessable. The event 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.

Other Meds:

Current Illness:

ID: 1236129
Sex: F
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: PAIN ON HER CHEST THAT WOULD COME AND GO; PAIN ON RIGHT LEG FROM FOOT TO THE UPPER THIGH; SWELLING OF FOOT AND LEG; TINGLING OF TOES; CANNOT FLEX RIGHT FOOT THAT MUCH; TONGUE FELT HEAVY; SWOLLEN PRONOUNCED VEINS ON BACK OF LEG; SWEATY; CHILLS; MALAISE; HEADACHE; FATIGUE; FEVER; This spontaneous report received from a consumer concerned a 45 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included synthetic dyes allergy, egg allergy, meat allergy, dairy allergy, and non smoker, and other pre-existing medical conditions included the patient has no drug abuse or illicit drug usage. the patient is non alcoholic.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and batch number: 201A21A expiry: 23/JUN/2021) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced pain on her chest that would come and go, pain on right leg from foot to the upper thigh, swelling of foot and leg, tingling of toes, cannot flex right foot that much, tongue felt heavy, swollen pronounced veins on back of leg, sweaty, chills, malaise, headache, fatigue, and fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tongue felt heavy, headache, and fatigue, had not recovered from fever, malaise, sweaty, chills, and pain on her chest that would come and go, and the outcome of pain on right leg from foot to the upper thigh, swelling of foot and leg, swollen pronounced veins on back of leg, tingling of toes and cannot flex right foot that much was not reported. This report was non-serious.; Sender's Comments: V0:Medical assessment comment not required as per standard procedure as case assessed as non serious.

Other Meds:

Current Illness: Allergy; Egg allergy; Meat allergy; Milk allergy; Non-smoker

ID: 1236130
Sex: F
Age:
State: TN

Vax Date:
Onset Date: 04/13/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: SLIGHT SHORTNESS OF BREATH; BODY ACHES; TINGLING IN INJECTED ARM; FEVER OF 100-102; HEADACHE; This spontaneous report received from a patient concerned a 29 year old female. 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: 041A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced slight shortness of breath. On 13-APR-2021, the subject experienced body aches. On 13-APR-2021, the subject experienced tingling in injected arm. On 13-APR-2021, the subject experienced fever of 100-102. On 13-APR-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 100-102. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever of 100-102, body aches, headache, tingling in injected arm, and slight shortness of breath. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment was not required as per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1236131
Sex: M
Age:
State: WA

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: LIGHT HEADED; This spontaneous report received from a patient concerned a male of unspecified age. 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: Unknown) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure no follow up will be requested. No concomitant medications were reported. On an unspecified date, the subject experienced light headed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from light headed. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236132
Sex: F
Age:
State: IL

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: DISCOMFORT IN THE FACE; SWELLING IN THE RIGHT SIDE OF THE FACE; SORE ARM; This spontaneous report received from a parent concerned an adult female. 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 and batch number: 041A21A expiry: UNKNOWN) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced discomfort in the face, swelling in the right side of the face, and sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the discomfort in the face, swelling in the right side of the face and sore arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236133
Sex: M
Age:
State: KY

Vax Date:
Onset Date: 04/12/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: VIAL LEFT IN ROOM TEMPERATURE MORE THAN 2 HOURS; This spontaneous report received from a pharmacist concerned a 73 year old male. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included no known medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced vial left in room temperature more than 2 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vial left in room temperature more than 2 hours was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236134
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: INSOMNIA; CHILLS ON AND OFF; FEVER; This spontaneous report received from a patient concerned a male of unspecified age. 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: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 2021, the subject experienced insomnia. On 2021, the subject experienced chills on and off. On 2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, chills on and off and insomnia was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236135
Sex: M
Age:
State: FL

Vax Date:
Onset Date: 04/05/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: CHILLS; NAUSEA; HOT FLASHES; FEELING HOT AND COLD; This spontaneous report received from a patient concerned a 61 year old male. 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 and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 05-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 05-APR-2021, the subject experienced hot flashes. On 05-APR-2021, the subject experienced feeling hot and cold. On 05-APR-2021, the subject experienced nausea. On 06-APR-2021, the subject experienced chills. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 98 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from hot flashes, chills, nausea, and feeling hot and cold. This report was non-serious. This case, from the same reporter is linked to 20210424684.

Other Meds:

Current Illness:

ID: 1236136
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 04/09/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: DIARRHEA; DIZZINESS; FUNNY TASTE; PAIN IN LEFT ARM; HEADACHES; NAUSEA; This spontaneous report received from a patient concerned a 62 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included chronic back pain, preexisting degenerative joint disease, non smoker, and non-alcohol user, and other pre-existing medical conditions included the patient did not have any drug abuse/illicit drug use and had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced diarrhea. On 09-APR-2021, the subject experienced dizziness. On 09-APR-2021, the subject experienced funny taste. On 09-APR-2021, the subject experienced pain in left arm. On 09-APR-2021, the subject experienced headaches. On 09-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea on 11-APR-2021, dizziness, and nausea on 10-APR-2021, and funny taste on 09-APR-2021, and had not recovered from pain in left arm, and headaches. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Chronic back pain; Degenerative joint disease; Non-smoker

ID: 1236137
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: FATIGUE; INJECTION SITE PAIN (LEFT SIDE); MUSCLE ACHES; HARD TIME MOVING HAND; This spontaneous report received from a patient concerned a 36 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included hypothyoid, pollen allergy, and zofan allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: 23/JUN/2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced hard time moving hand. On 12-APR-2021, the subject experienced injection site pain (left side). On 12-APR-2021, the subject experienced muscle aches. On 13-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from injection site pain (left side), muscle aches, and fatigue, and the outcome of hard time moving hand was not reported. This report was non-serious.

Other Meds:

Current Illness: Drug allergy; Hypothyroidism; Pollen allergy

ID: 1236138
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: LIGHT HEADEDNESS (HER HEAD DOES NOT FEEL CONNECTED TO HER BODY); LIGHT SENSITIVITY; FLU-LIKE SYMPTOMS; CHILLS; HEADACHE; NAUSEA; TIREDNESS; This spontaneous report received from a patient concerned a 61 year old female. The patient's weight was 106 pounds, and height was not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A-21A, expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced flu-like symptoms. On 10-APR-2021, the subject experienced chills. On 10-APR-2021, the subject experienced headache. On 10-APR-2021, the subject experienced nausea. On 10-APR-2021, the subject experienced tiredness. On 11-APR-2021, the subject experienced light sensitivity. On 12-APR-2021, the subject experienced light headedness (her head does not feel connected to her body). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu-like symptoms, chills, headache, and nausea on 11-APR-2021, and light sensitivity on 13-APR-2021, and was recovering from tiredness, and light headedness (her head does not feel connected to her body). This report was non-serious.

Other Meds:

Current Illness:

ID: 1236139
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: DIZZINESS; NAUSEA; This spontaneous report received from a consumer concerned a patient of unspecified age and 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: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced dizziness and nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the nausea and dizziness was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236140
Sex: U
Age:
State: MT

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: VIAL PAST STORAGE REQUIREMENT; MEDICATION ERROR; This spontaneous report received from a pharmacist concerned a patient of unspecified age and 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: Unknown) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced vial past storage requirement, and medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vial past storage requirement and medication error was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236141
Sex: F
Age:
State:

Vax Date:
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: FELT LIKE SHE WAS ON ACID TRIP/HER PHYSICAL BODY WAS FUNKY/WAS BIZARRE; CHILLS; FEVERISH; NAUSEA; HALLUCINATION; MORE SEVERE HEADACHE; This spontaneous report received from a consumer via company representative concerned a 67 year old female. The patient's height, and weight were not reported. The patient's past medical history included concussion. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose, 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. It was reported that, after vaccination the patient experienced chills, feverish, headache, and nausea. On 10-APR-2021 (in the middle of the night), the patient started hallucinating with a more severe headache and she felt like she was on an acid trip and her physical body was funky. The patient felt like she wanted to stretch her muscles but felt like she did not have control. At the time of this report, the patient said it was bizarre. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from more severe headache, and hallucination, and the outcome of feverish, chills, nausea and felt like she was on acid trip/her physical body was funky/was bizarre was not reported. This report was serious (Other Medically Important Condition).; Sender's Comments: V0: covid-19 vaccine ad26.cov2.s-Hallucination. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY

Other Meds:

Current Illness: Medical History/Concurrent Conditions: Concussion (2 weeks prior to getting the vaccine)

ID: 1236142
Sex: M
Age:
State: NJ

Vax Date:
Onset Date: 03/04/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: NECK PAIN; CHILLS; SHOULDER PAIN; This spontaneous report received from a consumer concerned a 65 year old. 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: 1805031, and expiry: 26-MAY-2021) dose was not reported, administered on 04-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-MAR-2021, the subject experienced neck pain. On 04-MAR-2021, the subject experienced chills. On 04-MAR-2021, the subject experienced shoulder pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from neck pain, chills, and shoulder pain. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236143
Sex: U
Age:
State: PA

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: COGNITIVE MEMORY RECALL ISSUES; EYE SWELLING; CHILLS; HEADACHE; FATIGUE; FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and 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: 043A21A, and expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced cognitive memory recall issues. On APR-2021, the subject experienced eye swelling. On APR-2021, the subject experienced chills. On APR-2021, the subject experienced headache. On APR-2021, the subject experienced fatigue. On APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from cognitive memory recall issues, eye swelling, chills, headache, fatigue, and fever on APR-2021. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1236144
Sex: U
Age:
State: CO

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: SICK; This spontaneous report received from a consumer concerned a patient of unspecified age and 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: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced sick. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of sick was not reported. This report was non-serious. This case is associated with PQC no. 90000176125. The suspected product quality complaint has been confirmed to be no PQC was identified within the complaint reported. Complaint has been approved for void, based on the PQC evaluation/investigation performed.

Other Meds:

Current Illness:

ID: 1236145
Sex: F
Age:
State: TN

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
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Vax Site:

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: STINGING AT INJECTION SITE; CHILLS; COULD BARELY WALK TO KITCHEN; NAUSEA; HEADACHE; FEVER; FATIGUE; WEAKNESS; LITTLE SORENESS AT INJECTION SITE; MAYBE A LITTLE BIT OF MENTAL CONFUSION; NECK PAIN; FELT LETHARGIC; HUNGER; LAST NIGHT WAS OUT OF IT AND COULD NOT DO ANYTHING; KNOCKED OUT FOR ABOUT 10 HOURS; This spontaneous report received from a patient concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's past medical history included pass out when younger due to allergies, and tingling in mouth before pass out, and concurrent conditions included history of allergic reactions to many different things, and penicillin and erythromycin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 09:00 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced hunger. On APR-2021, the subject experienced last night was out of it and could not do anything. On APR-2021, the subject experienced knocked out for about 10 hours. On 12-APR-2021, the subject experienced maybe a little bit of mental confusion. On 12-APR-2021, the subject experienced neck pain. On 12-APR-2021, the subject experienced felt lethargic. On 12-APR-2021, the subject experienced could barely walk to kitchen. On 12-APR-2021, the subject experienced nausea. On 12-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced fever. On 12-APR-2021, the subject experienced fatigue. On 12-APR-2021, the subject experienced weakness. On 12-APR-2021, the subject experienced little soreness at injection site. On 12-APR-2021 16:30, the subject experienced chills. On 13-APR-2021, the subject experienced stinging at injection site. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 102.5. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from stinging at injection site, was recovering from nausea, chills, maybe a little bit of mental confusion, little soreness at injection site, felt lethargic, and could barely walk to kitchen, had not recovered from headache, fever, fatigue, weakness, and neck pain, and the outcome of hunger, last night was out of it and could not do anything and knocked out for about 10 hours was not reported. This report was non-serious.

Other Meds:

Current Illness: Allergic reaction; Drug allergy

ID: 1236146
Sex: F
Age:
State: OH

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/21/2021
Hospital:

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Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: ELEVATED D-DIMER; SHORTNESS OF BREATH; COLD; GOT SICK; This spontaneous report received from a parent concerned a 22 year old female. 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: 205A21A expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced shortness of breath. On 07-APR-2021, the subject experienced cold. On 07-APR-2021, the subject experienced got sick. On 09-APR-2021, the subject experienced elevated d-dimer. Laboratory data included: Fibrin D dimer (NR: not provided) elevated levels of 0.6. On 09-APR-2021 15:30, Laboratory data included: CT scan (NR: not provided) negative for blood clots. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the cold, got sick, shortness of breath and elevated d-dimer was not reported. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1236147
Sex: M
Age:
State: NY

Vax Date:
Onset Date: 03/31/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
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Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: TIRED; This spontaneous report received from a parent concerned a 25 year old. 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) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 31-MAR-2021, the subject experienced tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tired on 31-MAR-2021. This report was non-serious. This case, from the same reporter is linked to 20210424198.

Other Meds:

Current Illness:

ID: 1236148
Sex: F
Age:
State: MN

Vax Date:
Onset Date: 04/10/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: LEFT ARM SORE; NAUSEOUS; HEADACHE; TIREDNESS; DIZZINESS; This spontaneous report received from a patient concerned a 19 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included iron deficient. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203AZIA, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced dizziness. On 10-APR-2021, the subject experienced tiredness. On 10-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced left arm sore. On 12-APR-2021, the subject experienced nauseous. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tiredness, and headache, was recovering from dizziness, and had not recovered from left arm sore, and nauseous. This report was non-serious.

Other Meds:

Current Illness: Iron deficiency

ID: 1236149
Sex: F
Age:
State: OH

Vax Date:
Onset Date: 04/09/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: NUMBNESS IN CHEEKS; TINGLING PINS AND NEEDLES; GROGGY; FELT GROSS; SWEATY; NAUSEA; VERY TIRED; HEADACHE; CHILLS AND FEVERS; This spontaneous report received from a patient concerned a 27 year old female. 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: 205A264, expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 13:30 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021 22:00, the subject experienced chills and fevers. On 10-APR-2021, the subject experienced sweaty. On 10-APR-2021, the subject experienced nausea. On 10-APR-2021, the subject experienced very tired. On 10-APR-2021, the subject experienced headache. On 10-APR-2021 10:00, the subject experienced groggy. On 10-APR-2021 10:00, the subject experienced felt gross. On 11-APR-2021 22:00, the subject experienced tingling pins and needles. On 12-APR-2021, the subject experienced numbness in cheeks. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sweaty, groggy, felt gross, nausea, and headache, and chills and fevers on 10-APR-2021, had not recovered from tingling pins and needles, and very tired, and the outcome of numbness in cheeks was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236150
Sex: F
Age:
State: NC

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: HEART RATE HIGH; CHILLS; DIFFICULTY BREATHING/SHORTNESS OF BREATH; COUGHING; FEELING ANXIOUS; HEADACHE; FEELING UNWELL; INJECTION SITE SORE; INJECTION SITE WARMTH; FATIGUE; TIREDNESS; This spontaneous report received from a patient concerned a 54 year old female. 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: 042A21A, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021, the subject experienced injection site warmth. On 08-APR-2021, the subject experienced injection site sore. On 08-APR-2021, the subject experienced fatigue. On 08-APR-2021, the subject experienced tiredness. On 10-APR-2021, the subject experienced feeling unwell. On 10-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced difficulty breathing/shortness of breath. On 12-APR-2021, the subject experienced coughing. On 12-APR-2021, the subject experienced feeling anxious. On 13-APR-2021, the subject experienced heart rate high. On 13-APR-2021, the subject experienced chills. Laboratory data included: Heart rate (NR: not provided) unknown, and Pulse rate (NR: not provided) 105. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, and the outcome of injection site sore, injection site warmth, fatigue, difficulty breathing/shortness of breath, coughing, heart rate high, tiredness, feeling unwell, chills and feeling anxious was not reported. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure as the case was assessed as non-serious

Other Meds:

Current Illness:

ID: 1236151
Sex: F
Age:
State: KS

Vax Date:
Onset Date: 04/12/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
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Lot:
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Lab Data:

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: SWEATY AFTER FEVER BROKE; FLU FEELING; MUSCLE SORENESS; CHILLS; FRONTAL HEADACHE; This spontaneous report received from a patient concerned a 50 year old female. The patient's weight was 173 pounds, and height was not reported. The patient's concurrent conditions included ehlers-danlos syndrome, sjogren's syndrome, and blood clotting disorder.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and batch number: 203A21A expiry: 23-JUN-2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced frontal headache. On 13-APR-2021, the subject experienced sweaty after fever broke. On 13-APR-2021, the subject experienced flu feeling. On 13-APR-2021, the subject experienced muscle soreness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sweaty after fever broke, flu feeling, chills, frontal headache, and muscle soreness on 13-APR-2021. This report was non-serious.

Other Meds:

Current Illness: Clotting disorder; Ehlers-Danlos syndrome; Sjogren's syndrome

ID: 1236152
Sex: M
Age:
State: CA

Vax Date:
Onset Date: 03/31/2021
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: SHORTNESS OF BREATH; LEG CRAMPS; KNOT AT INJECTION SITE ON RIGHT ARM; HEADACHE; This spontaneous report received from a patient concerned a male of unspecified age. The patient's height, and weight were not reported. The patient's concurrent conditions included sulfa allergy, penicillin allergy, non alcohol user, and non smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, and expiry: UNKNOWN) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 31-MAR-2021, the subject experienced headache. On 01-APR-2021, the subject experienced knot at injection site on right arm. On 10-APR-2021, the subject experienced shortness of breath. On 10-APR-2021, the subject experienced leg cramps. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headache, and had not recovered from knot at injection site on right arm, leg cramps, and shortness of breath. This report was non-serious.; Sender's Comments: V0 Medical assessment comment not required as per standard procedure as the case was assessed as non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy; Sulfonamide allergy

ID: 1236153
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: SORE ARM; MILD HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. 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: unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, the batch number will not be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced sore arm, and mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the sore arm and mild headache was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1236154
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: DIZZY; "JOINTS KILLED ME"; ACHY; This spontaneous report was received from a consumer and concerned a female patient of an unspecified age with an unknown race and unknown ethnicity. 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: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient experienced achy, "joints killed me", and dizzy. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the achy, "joints killed me" and dizzy was not reported. This report was non-serious.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am