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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1390701



Case Details

VAERS ID: 1390701 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210614695

Write-up: VACCINE ADMINISTERED AFTER THE 6 HOUR MARK AFTER FIRST PUNCTURE IN REFRIGERATED CONDITIONS; INCORRECT STORAGE OF DRUG; This spontaneous report received from a pharmacist concerned a 20 year old of unspecified sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 205A21A, and expiry: 23/JUN/2021) dose was not reported, administered on 04-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-JUN-2021, the subject experienced vaccine administered after the 6 hour mark after first puncture in refrigerated conditions. On 04-JUN-2021, the subject experienced incorrect storage of drug. The action taken with covid-19 vaccine was not applicable. The outcome of the vaccine administered after the 6 hour mark after first puncture in refrigerated conditions and incorrect storage of drug was not reported. This report was non-serious.


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