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VAERS Report 2157414

Case Report Section

Vaer Report Details

Age: 60 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (JANSSEN))

Type: Coronavirus 2019 vaccine

Manufacturer: JANSSEN

Lot: xd974


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-09-20
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

vision decreased; this spontaneous report received from a consumer by a regulatory authority (it-minisal02-846615) on 28-feb-2022 concerned a 60 year old female. the patient's weight was 58 kilograms, and height was 160 centimeters. 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: unknown) 1 dosage forms, 1 total, administered on 20-sep-2021 for vaccination. no concomitant medications were reported. on 20-sep-2021, the patient experienced vision decreased (worsening of day and night vision od(most probably meaning right eye from 'oculus dextrus') already suffering from retinal pathology photophobia). the action taken with covid-19 vaccine ad26.cov2.s was not applicable. the patient had not recovered from vision decreased. this report was serious (disability or permanent damage).; reporter's comments: glaucoma; already suffering from retinal pathology photophobia

Lab Data
na
List of symptoms
visual impairment
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
Yes
Allergies:
na
Current Illness
na