National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1469611

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1469611
VAERS Form:2
Age:34.0
Sex:Unknown
Location:Minnesota
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted:0000-00-00
Entered:2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Product storage error, 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': USJNJFOC20210710769

Write-up: PRODUCT STORAGE ERROR; PUNCTURED VACCINE DOSE ADMINISTERED TO PATIENT AFTER 6 HOUR HOLD PERIOD IN REFRIGERATOR; This spontaneous report received from a pharmacist concerned a 34 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: 203A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 03-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced product storage error. On 03-JUL-2021, the subject experienced punctured vaccine dose administered to subject after 6 hour hold period in refrigerator. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the product storage error and punctured vaccine dose administered to patient after 6 hour hold period in refrigerator was not reported. This report was non-serious.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1469611&WAYBACKHISTORY=ON


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