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This is VAERS ID 1381358

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1381358
VAERS Form:2
Age:
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 201A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Haemorrhage

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: SERTRALINE
Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USJNJFOC20210612348

Write-up: EXCESSIVE BLEEDING; This spontaneous report received from a patient concerned a other, Hispanic or Latino male of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included no alcohol, non-smoker, penicillin allergy. The patient experienced drug allergy when treated with clarithromycin for drug used for unknown indication. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: unknown) dose was not reported, 1 total dose was administered on 04-JUN-2021 to right arm for prophylactic vaccination. Concomitant medications included Sertraline (100 mg once daily) used for unknown indication. On 04-JUN-2021, the patient experienced excessive bleeding when he tried to cut his nails and scratch his beard but the bleeding did not stop. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from excessive bleeding. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0.20210612348-Covid-19 vaccine ad26.cov2.s -excessive bleeding . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).

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