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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1442768



Case Details

VAERS ID: 1442768 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, Off label use
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: USJNJFOC20210661376

Write-up: REVACCINATED/PATIENT RECEIVED 2 DOSES OF THE JANSSEN COVID19 VACCINE; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 50 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 ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, administered on APR-2021, and dose was not reported, administered on 25-JUN-2021 13:15 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced revaccinated/subject received 2 doses of the janssen covid19 vaccine. On 25-JUN-2021, the subject experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the revaccinated/patient received 2 doses of the janssen covid19 vaccine and off label use was not reported. This report was non-serious.


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