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This is VAERS ID 1375695

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1375695
VAERS Form:2
Age:
Sex:Male
Location:Ohio
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1821288 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Poor quality product administered

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210605149

Write-up: This spontaneous report received from a pharmacist concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821288, expiry: 01-AUG-2021) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced stored in the fridge for over 6 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of stored in the fridge for over 6 hours was not reported. This report was non-serious.

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