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VAERS ID: 1787215

AGE: UNK| SEX: F|State: FR

Description

DRUG INEFFECTIVE; This spontaneous report received from a physician via Regulatory Authority (EVHUMAN Vaccines, PT-INFARMED-T202109-1987) on 08-OCT-2021 and concerned a 39 year old female of unknown race and ethnicity. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 21C19-02 and expiry: UNKNOWN) 0.5 ml, 1 total, administered on 17-AUG-2021 for covid-19 immunisation. No concomitant medications were reported. On an unspecified date, the patient experienced drug ineffective. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of drug ineffective was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint.

Symptoms

Drug ineffective

Vaccines

VAX DATE: | ONSET DATE: | DAYS TO ONSET:
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • JANSSEN
  • COVID19 (COVID19 (JANSSEN))

        RECVDATE:
        15 October 2021
        CAGE_YR:
        CAGE_MO:
        RPT_DATE:
        DIED:
        DATEDIED:
        L_THREAT:
        ER_VISIT:
        HOSPITAL:
        HOSPDAYS:
        X_STAY:
        DISABLE:
        RECOVD:
        U
        LAB_DATA:
        V_ADMINBY:
        OTH
        OTHER_MEDS:
        CUR_ILL:
        HISTORY:
        PRIOR_VAX:
        SPLTTYPE:
        PTJNJFOC20211015191
        FORM_VERS:
        2
        TODAYS_DATE:
        11 October 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY:
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