Adverse Event Reporting

VAERS ID 1075575
Gender Female
Age 50
StateCode MS
Pharmaceutical Company JANSSEN
Lot Number 1805020
Number of vaccinations 1
Vaccinated 2021-03-04
Onset 2021-03-04
Condition Recovered
  • Blood pressure increased
  • Palpitations
  • Swelling face

Current Illness

Preexisting Conditions

seasonal allergies, BMI >/= 30

Other Medications

Xyzal 5 mg po daily

Previous Vaccinations


Sulfa (purple rash)

Laboratory Data



14:59 - RN responded to waiting lot.
Pt c/o sensation of facial swelling and heart racing.
Denied other complaints.
At 1500 BP 110/80, HR 140, R 12.
1503: Pt helt HR slowing down.
No further feeling of swelling in face, throat, or elsewhere.
1505: HR 128.
1510: Pt talking, breathing without difficulty.
Advised to seek medical attention if s/sx worsen.
3/5/21 @ 1040: Another RN followed up with ph call.
Pt reported that after leaving site, she felt HR beginning to speed up.
Went to ED and was monitored x 2 hrs.
Systolic pressure there was 161.
HR was in 140's.
No interventions.
After 2 hrs VS stabilized and pt was discharged home.
Is fine today.