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VAERS ID: 1787265

AGE: UNK| SEX: F|State: FR

Description

MENSTRUAL CYCLE ABNORMAL; ALLERGY NOS; This spontaneous report received from a physician via a Regulatory Authority (RO-NMA-2021-SPCOV12782) on 12-OCT-2021 and concerned a 39 year old female. The patient's weight was 63 kilograms, and height was 167 centimeters. No past medical history or concurrent conditions were reported. On 15-MAR-2021, Laboratory data included: COVID-19 (NR: not provided) Positive. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 21C18- 05 expiry: UNKNOWN) 1 dosage forms, 1 total, administered on 26-AUG-2021 for product used for unknown indication. No concomitant medications were reported. On an unspecified date, the patient experienced menstrual cycle abnormal (irregular menstrual cycle with brown blood clots), and allergy nos. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from menstrual cycle abnormal, and allergy nos. This report was serious (Disability Or Permanent Damage).

Symptoms

COVID-19, Hypersensitivity, Menstrual disorder

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:
        Y
        RECOVD:
        N
        LAB_DATA:
        Test Date: 20210315; Test Name: COVID-19; Result Unstructured Data: Positive
        V_ADMINBY:
        OTH
        OTHER_MEDS:
        CUR_ILL:
        HISTORY:
        PRIOR_VAX:
        SPLTTYPE:
        ROJNJFOC20211021341
        FORM_VERS:
        2
        TODAYS_DATE:
        13 October 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY:
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