return to results page

VAERS ID: 1787223

AGE: UNK| SEX: M|State: FR

Description

VACCINATION FAILURE; This spontaneous report received from a physician by a Regulatory Authority (PT-INFARMED-T202109-2311) on 12-OCT-2021 and concerned a 27-year-old male of unspecified race and ethnicity. 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: XE393 expiry: unknown) 0.5 ml, 1 total, administered on 14-JUL-2021 for covid-19 immunisation. No concomitant medications were reported. On 21-SEP-2021, the patient had vaccination failure. Laboratory data included: severe acute respiratory syndrome coronavirus (SARS-CoV-2 test) (NR: not provided), Positive Iu international unit (s). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint:; Reporter's Comments: Other information Test Date +: 21-Sep-2021. Laboratory Notification: 23575657. Symptoms: Yes. Symptom onset date: 20-Sep-2021

Symptoms

SARS-CoV-2 test, Vaccination failure

Vaccines

VAX DATE: | ONSET DATE: 21 September 2021 | 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:
        Test Date: 20210921; Test Name: SARS-CoV-2 test; Result Unstructured Data: Positive Iu international unit(s)
        V_ADMINBY:
        OTH
        OTHER_MEDS:
        CUR_ILL:
        HISTORY:
        PRIOR_VAX:
        SPLTTYPE:
        PTJNJFOC20211020992
        FORM_VERS:
        2
        TODAYS_DATE:
        13 October 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY:
        return to results page

        Questions? Comments? Bugs?
        [email protected]
        Due to the high volume of inquiries, please be patient with response times.

        AND PLEASE read the FAQ first.

        OpenVAERS is a private organization that posts publicly available CDC/FDA data of injuries reported post-vaccination. Reports are not proof of causality.