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VAERS Report 2115868

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (JANSSEN))

Type : Coronavirus 2019 vaccine

Fabricant: JANSSEN

Lot: xd974


Date de réception du rapport
2022-02-16
Date à laquelle le formulaire est complèté
Date de vaccination
2021-06-18
Date d’apparition
140
Nombre de jours (date d’apparition – date de vaccination)
140
Description de l’événement indésirable

sars-cov-2 infection; vaccination failure; this spontaneous report received from a physician by a regulatory authority (ra, at-basgages-2022-003051) on 14-feb-2022 concerned a 35 year old female of an unspecified race and ethnic origin. the patient's height and weight were not reported. no past medical history or concurrent conditions were reported. the patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: xd974 and expiry: unknown) dose was not reported, dose number in series was 1, 01 total administered on 18-jun-2021 for an unspecified indication. no concomitant medications were reported. on 05-nov-2021, the patient experienced severe acute respiratory syndrome coronavirus 2 (sars-cov-2) infection and had vaccination failure (dose number in series was 1). on the same day she had laboratory test included: coronavirus disease polymerase chain reaction (covid-19 pcr) test with positive result. the action taken with covid-19 vaccine ad26.cov2.s was not applicable. the outcome of the sars-cov-2 infection and vaccination failure was not reported. this report was serious (other medically important condition). this report was associated with product quality complaint

Données de laboratoire
test date: 20211105; test name: covid-19 pcr test; result unstructured data: positive
Liste des symptômes
covid-19 sars-cov-2 test vaccination failure
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na