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This is VAERS ID 1245121

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1245121
VAERS Form:2
Age:
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Medication error, Product storage error

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210436473

Write-up: MEDICATION ERROR; TEMPERATURE EXCURSION EXPOSURE/ NO MORE TEMPERATURE WAS RECORDED FOR ABOUT 3 HOURS AND 20 MINUTES PAST THE LAST RECORDED WITHIN RANGE TEMPERATURE; This spontaneous report received from a pharmacist concerned a 52 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included augmentin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and batch number: 201A21A expiry: 23-JUN-2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced temperature excursion exposure/ no more temperature was recorded for about 3 hours and 20 minutes past the last recorded within range temperature. On an unspecified date, the subject experienced medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the temperature excursion exposure/ no more temperature was recorded for about 3 hours and 20 minutes past the last recorded within range temperature and medication error was not reported. This report was non-serious.


Changed on 5/7/2021

VAERS ID: 1245121 Before After
VAERS Form:2
Age:
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Medication error, Product storage error

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210436473

Write-up: MEDICATION ERROR; TEMPERATURE EXCURSION EXPOSURE/ NO MORE TEMPERATURE WAS RECORDED FOR ABOUT 3 HOURS AND 20 MINUTES PAST THE LAST RECORDED WITHIN RANGE TEMPERATURE; This spontaneous report received from a pharmacist concerned a 52 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included augmentin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and batch number: 201A21A expiry: 23-JUN-2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced temperature excursion exposure/ no more temperature was recorded for about 3 hours and 20 minutes past the last recorded within range temperature. On an unspecified date, the subject experienced medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the temperature excursion exposure/ no more temperature was recorded for about 3 hours and 20 minutes past the last recorded within range temperature and medication error was not reported. This report was non-serious.


Changed on 5/14/2021

VAERS ID: 1245121 Before After
VAERS Form:2
Age:
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Medication error, Product storage error

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210436473

Write-up: MEDICATION ERROR; TEMPERATURE EXCURSION EXPOSURE/ NO MORE TEMPERATURE WAS RECORDED FOR ABOUT 3 HOURS AND 20 MINUTES PAST THE LAST RECORDED WITHIN RANGE TEMPERATURE; This spontaneous report received from a pharmacist concerned a 52 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included augmentin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and batch number: 201A21A expiry: 23-JUN-2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced temperature excursion exposure/ no more temperature was recorded for about 3 hours and 20 minutes past the last recorded within range temperature. On an unspecified date, the subject experienced medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the temperature excursion exposure/ no more temperature was recorded for about 3 hours and 20 minutes past the last recorded within range temperature and medication error was not reported. This report was non-serious.

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