VAERS ID: 2331383

AGE: | SEX: U|STATE: FR

Description

TRANSIENT LOSS OF CONSCIOUSNESS; FEVER; This spontaneous report received from a physician by a Regulatory Authority (RA, PL-URPL-3-14833-2021) on 22-JUN-2022 and concerned a 21 year old of unspecified sex, 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: XE423 expiry: 14-NOV-2021) dose was not reported, 01 total (dose 1), administered on 31-AUG-2021 at 13:15 for covid-19 immunisation. No concomitant medications were reported. On 01-SEP-2021 at 09:00, the patient experienced transient loss of consciousness (momentary loss of consciousness), and fever (highest temperature: 38.538.9). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from transient loss of consciousness, and fever on 02-SEP-2021. This report was serious (Other Medically Important Condition).

Symptoms

Loss of consciousness, Pyrexia

Vaccines

VAX DATE: 08-31-2021| ONSET DATE: 09-01-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (JANSSEN)) 1 COVID19 JANSSEN XE423 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:Y
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:PLJNJFOC20220644247
FORM_VERS:2
TODAYS_DATE:06-24-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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