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VAERS Report 2136745

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (JANSSEN))

Type : Coronavirus 2019 vaccine

Fabricant: JANSSEN

Lot: 21c11-02


Date de réception du rapport
2022-02-24
Date à laquelle le formulaire est complèté
Date de vaccination
2021-05-30
Date d’apparition
31
Nombre de jours (date d’apparition – date de vaccination)
31
Description de l’événement indésirable

fatigue; myalgia; peripheral neuropathy; this spontaneous report received from a consumer by a regulatory authority (nl-lrb-00740693) on 22-feb-2022 concerned a 53 year old female of unspecified race and ethnicity. the patient's weight was 81 kilograms, and height was 174 centimeters. the patient's past medical history included: covid-19. the patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 21c11-02 expiry: unknown) 1 dosage forms, 1 total (first dose) administered on 30-may-2021 for covid-19 immunisation. no concomitant medications were reported. on 30-jun-2021, the patient experienced fatigue, myalgia, and peripheral neuropathy. on 26-dec-2021, laboratory data included: sars-cov-2 test (severe acute respiratory syndrome) positive (nr: not provided) positive. the action taken with covid-19 vaccine ad26.cov2.s was not applicable. the patient had not recovered from fatigue, myalgia, and peripheral neuropathy. this report was serious (other medically important condition)

Données de laboratoire
test date: 20211226; test name: sars-cov-2 test positive; result unstructured data: positive
Liste des symptômes
fatigue myalgia neuropathy peripheral sars-cov-2 test positive
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na