VAERS ID: 2331384

AGE: 18| SEX: U|STATE: FR

Description

LEG PAIN; ANEMIA; ABDOMINAL PAIN; FEVER; This spontaneous report received from a physician by a Regulatory Authority (RA, PL-URPL-3-14987-2021) on 22-JUN-2022 concerned an 18 year old of unspecified sex, race and ethnic origin. 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: XE389 expiry: 06-OCT-2021) dose was not reported, 1 total (dose 1) administered on 26-AUG-2021 08:37 for covid-19 immunisation. Age at time of vaccination 18 years old. No concomitant medications were reported. On 26-AUG-2021 at 16:00, the patient experienced leg pain (leg stinging), anemia (severe anemia), abdominal pain and fever (highest temperature: 39.039.4). The duration of event fever was 24 hours. On an unspecified date, Laboratory data included: Hemoglobin C (NR: not provided) 5.9 g/dL. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 27-AUG-2021, and the outcome of leg pain, anemia and abdominal pain was not reported (also conflictingly reported with an end date of 27-AUG-2021). This report was serious (Other Medically Important Condition).

Symptoms

Abdominal pain, Anaemia, Haemoglobin C, Pain in extremity, Pyrexia

Vaccines

VAX DATE: 08-26-2021| ONSET DATE: 08-26-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (JANSSEN)) 1 COVID19 JANSSEN XE389 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:Test Name: HCB; Result Unstructured Data: 5.9 g/dL
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:PLJNJFOC20220644657
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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