Vaer Report Details
Age: 60 years old
Gender: Female
State: Outside US
- Patient Died?
- No
- Vaccine information
-
Name: COVID19 (COVID19 (JANSSEN))
Type: Coronavirus 2019 vaccine
Manufacturer: JANSSEN
Lot: xd974
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-09-20
- Date of Onset
- 0
- Number of days (onset date – vaccination date)
- 0
- Adverse Event Description
-
vision decreased; this spontaneous report received from a consumer by a regulatory authority (it-minisal02-846615) on 28-feb-2022 concerned a 60 year old female. the patient's weight was 58 kilograms, and height was 160 centimeters. 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 expiry: unknown) 1 dosage forms, 1 total, administered on 20-sep-2021 for vaccination. no concomitant medications were reported. on 20-sep-2021, the patient experienced vision decreased (worsening of day and night vision od(most probably meaning right eye from 'oculus dextrus') already suffering from retinal pathology photophobia). the action taken with covid-19 vaccine ad26.cov2.s was not applicable. the patient had not recovered from vision decreased. this report was serious (disability or permanent damage).; reporter's comments: glaucoma; already suffering from retinal pathology photophobia
- Lab Data
-
na
- List of symptoms
-
visual impairment
- Patient Died?
- No
- Date Died
- NA
- Birth defect
- false
- Vaccine Administered By:
- Other
- Vaccine Purchased By:
- Unknown
- Patient visit ER?
- No
- Patient Hospitalized?
- No
- Stay in hospital
- No
- Days in hospital
- Unspecified
- Permanent disability?
- Yes
- Allergies:
-
na
- Current Illness
-
na