VAERS ID: 2331381

AGE: 32| SEX: U|STATE: FR

Description

TRANSIENT ALTERATION OF AWARENESS; ANAPHYLACTIC REACTION TO VACCINE; LOSS OF CONSCIOUSNESS; BRONCHOSPASM; VOMITING; BLOOD PRESSURE DROPPED; This spontaneous report received from a physician by a Regulatory Authority (RA, PL-URPL-3-14774-2021) on 22-JUN-2022 and concerned a 32 year old of unspecified sex, race and ethnic 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: XD974 expiry: 1-FEB-2023) .5 ml, 1 total, administered on 14-JUL-2021 for covid-19 immunisation. Age at time of vaccination 32 years old. No concomitant medications were reported. On 14-JUL-2021, the patient experienced transient alteration of awareness (disorders awareness), anaphylactic reaction to vaccine (anaphylactic shock/anaphylactic reaction), loss of consciousness, bronchospasm, vomiting, and blood pressure dropped. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the transient alteration of awareness, anaphylactic reaction to vaccine, loss of consciousness, bronchospasm, vomiting and blood pressure dropped was not reported. This report was serious (Other Medically Important Condition).

Symptoms

Altered state of consciousness, Anaphylactic reaction, Blood pressure decreased, Bronchospasm, Loss of consciousness, Vomiting

Vaccines

VAX DATE: 07-14-2021| ONSET DATE: 07-14-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (JANSSEN)) 1 COVID19 JANSSEN XD974 Unknown Unknown

RECVDATE:06-24-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:PLJNJFOC20220644285
FORM_VERS:2
TODAYS_DATE:06-23-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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