National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1398275

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1398275
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Chills, Fatigue, Headache, Hyperpyrexia, Myalgia, SARS-CoV-2 test positive

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: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20201226; Test Name: SARS-CoV-2 test positive; Result Unstructured Data: Positive; Test Date: 20210601; Test Name: Hyperpyrexia; Result Unstructured Data: Fever: 40.5 up to and including 42 degrees Celsius
CDC 'Split Type': NLJNJFOC20210619230

Write-up: FEVER: 40.5 UP TO AND INCLUDING 42 DEGREES CELSIUS; COLD CHILLS; MUSCLE PAIN; FATIGUE; HEADACHE; This spontaneous report received from a consumer via a Regulatory Authority [EMEA EVHUMAN NLP, NL-LRB-00565289] concerned a 53 year old female. The patient''s weight was 75 kilograms, and height was 165 centimeters. The patient''s past medical history included covid-19. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: XD975 expiry: UNKNOWN) 0.5 ml, 1 total, administered on 31-MAY-2021 for covid-19 immunisation. No concomitant medications were reported. On 26-DEC-2020, Laboratory data included: SARS-CoV-2 test positive (NR: not provided) Positive. On 01-JUN-2021, the patient had fever: 40.5 up to and including 42 degrees Celsius. On the same day, the patient had cold chills, muscle pain, fatigue and headache. Laboratory data included: Hyperpyrexia (NR: not provided) Fever: 40.5 up to and including 42 degrees Celsius. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever: 40.5 up to and including 42 degrees Celsius, fatigue, headache, muscle pain, and cold chills. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210619230- Covid-19 vaccine ad26.cov2.s- Fever: 40.5 up to and including 42 degrees Celsius. 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).

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1398275&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166