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