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This is VAERS ID 1325854

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1325854
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: SARS-CoV-2 test, Suspected COVID-19

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: Premenstrual syndrome
Preexisting Conditions: Comments: The patient never had a reaction to a vaccine. She takes flu shot every year.
Diagnostic Lab Data: Test Date: 20210511; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC 'Split Type': USJNJFOC20210523464

Write-up: SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included premenstrual syndrome, and other pre-existing medical conditions included the patient never had a reaction to a vaccine. she takes flu shot every year. The patient was previously treated with influenza vaccine for prophylactic vaccination. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 04-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 04-MAY-2021, the subject experienced suspected covid-19 infection. On 11-MAY-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Positive. The action taken with covid-19 vaccine was not applicable. The outcome of suspected covid-19 infection was not reported. This report was non-serious. The suspected product quality complaint has been confirmed to be management approval - confirmed no PQC was identified within the reported complaint reported. complaint is approved for void. void: yes based on the PQC evaluation/investigation performed.; Sender''s Comments: V0: Medical assessment comments not required as per standard procedure as the case is assessed non serious.

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