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This is VAERS ID 1481082

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1481082
VAERS Form:2
Age:47.0
Sex:Male
Location:Texas
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted:0000-00-00
Entered:2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Streptococcal infection, Culture, Streptococcus test, COVID-19

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: Alcoholic (Beer twice a week.); Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies. The patient did not have had any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: Streptococcus identification test; Result Unstructured Data: Positive; Test Date: 20210705; Test Name: Culture nose; Result Unstructured Data: Positive
CDC 'Split Type': USJNJFOC20210713761

Write-up: CONFIRMED COVID-19 INFECTION; STREPTOCOCCUS BACTERIAL INFECTION; This spontaneous report received from a patient concerned a 47 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-smoker, and alcoholic, and other pre-existing medical conditions included the patient had no known allergies. the patient did not have had any drug abuse/illicit drug use. 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 25-JUN-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced streptococcus bacterial infection. Laboratory data included: Streptococcus identification test (NR: not provided) Positive. On 05-JUL-2021, the subject experienced confirmed covid-19 infection. Laboratory data included: Culture nose (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed covid-19 infection, and the outcome of streptococcus bacterial infection was not reported. This report was non-serious.; Sender''s Comments: V0 Medical assessment comment not required as per standard procedure as the case was assessed as non-serious.

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