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This is VAERS ID 1442774

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1442774
VAERS Form:2
Age:
Sex:Unknown
Location:California
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 UNKNOWN / 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': USJNJFOC20210664597

Write-up: OUT OF SPECIFICATION PRODUCT USED; This spontaneous report received from a health care professional concerned a patient of unspecified age and 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: 206A21A expiry: 07-AUG-2021) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced out of specification product used. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of out of specification product used was not reported. This report was non-serious.

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