Détails du rapport Vaer
Âge: 34 ans
Genre: Male
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (JANSSEN))
Type : Coronavirus 2019 vaccine
Fabricant: JANSSEN
Lot: unknown
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-07-27
- Date d’apparition
- 0
- Nombre de jours (date d’apparition – date de vaccination)
- 0
- Description de l’événement indésirable
-
dizziness; difficulty in standing; paresthesia; fatigue; this spontaneous report received from a consumer by a regulatory authority (ie-hpra-2022-092955) on 02-mar-2022 concerned a 34 year old male of unspecified race and ethnicity. the patient's weight was 82.628 kilograms, and height was not reported. the patient's concurrent conditions included: childhood asthma, and other pre-existing medical conditions included: childhood asthma. the patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) 0.5 ml, 1 total (first dose) administered on 27-jul-2021 for covid-19 immunization. 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 27-jul-2021, the patient experienced dizziness, difficulty in standing, paresthesia, and fatigue. the action taken with covid-19 vaccine ad26.cov2.s was not applicable. the patient had not recovered from dizziness, difficulty in standing, paresthesia, and fatigue. this report was serious (disability or permanent damage)
- Données de laboratoire
-
na
- Liste des symptômes
-
paraesthesia fatigue dizziness dysstasia
- 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?
- Oui
- Allergies:
-
na
- Maladie actuelle
-
childhood asthma