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VAERS Report 2157162

Case Report Section

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