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This is VAERS ID 1264452

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1264452
VAERS Form:2
Age:45.0
Sex:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 182070 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Therapy non-responder, Antibody test

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:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: Antibody test; Result Unstructured Data: Test showed no antibodies.
CDC 'Split Type': USJNJFOC20210445661

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 45 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 182070, and expiry: UNKNOWN) dose was not reported, administered 1 total on 14-MAR-2021 around 12:00 PM at right arm for prophylactic vaccination. No concomitant medications were reported. On 19-APR-2021 the patient had a antibody test for Immunoglobulin M (IGM) and Immunoglobulin G (IGG) antibodies, and the antibody test showed no antibodies. She did the antibody test at home as she was part of a home clinical trial. Test results suggested that the patient experienced confirmed immunological vaccine failure. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 : 20210445661- covid-19 vaccine ad26.cov2.s-CONFIRMED IMMUNOLOGICAL VACCINE FAILURE. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS.


Changed on 5/7/2021

VAERS ID: 1264452 Before After
VAERS Form:2
Age:45.0
Sex:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 182070 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Therapy non-responder, Antibody test

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:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: Antibody test; Result Unstructured Data: Test showed no antibodies.
CDC 'Split Type': USJNJFOC20210445661

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 45 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 182070, and expiry: UNKNOWN) dose was not reported, administered 1 total on 14-MAR-2021 around 12:00 PM at right arm for prophylactic vaccination. No concomitant medications were reported. On 19-APR-2021 the patient had a antibody test for Immunoglobulin M (IGM) and Immunoglobulin G (IGG) antibodies, and the antibody test showed no antibodies. She did the antibody test at home as she was part of a home clinical trial. Test results suggested that the patient experienced confirmed immunological vaccine failure. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 : 20210445661- covid-19 vaccine ad26.cov2.s-CONFIRMED IMMUNOLOGICAL VACCINE FAILURE. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS.


Changed on 5/14/2021

VAERS ID: 1264452 Before After
VAERS Form:2
Age:45.0
Sex:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 182070 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Therapy non-responder, Antibody test

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:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: Antibody test; Result Unstructured Data: Test showed no antibodies.
CDC 'Split Type': USJNJFOC20210445661

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 45 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 182070, and expiry: UNKNOWN) dose was not reported, administered 1 total on 14-MAR-2021 around 12:00 PM at right arm for prophylactic vaccination. No concomitant medications were reported. On 19-APR-2021 the patient had a antibody test for Immunoglobulin M (IGM) and Immunoglobulin G (IGG) antibodies, and the antibody test showed no antibodies. She did the antibody test at home as she was part of a home clinical trial. Test results suggested that the patient experienced confirmed immunological vaccine failure. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 : 20210445661- covid-19 vaccine ad26.cov2.s-CONFIRMED IMMUNOLOGICAL VACCINE FAILURE. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS.

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