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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1742410

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Case Details

VAERS ID: 1742410 (history)  
Form: Version 2.0  
Sex: Female  
Location: Foreign  
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Vaccination failure
SMQs:, Lack of efficacy/effect (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Obesity
Preexisting Conditions: Comments: Unknown
Diagnostic Lab Data:
CDC Split Type: FRJNJFOC20210951573

Write-up: Vaccination failure; This spontaneous report received from a health care professional via a Regulatory Authority (EVHUMAN Vaccines, FR-AFSSAPS-NY20214399) on 27-SEP-2021 and concerned a 64 year old female of unknown race and ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: obesity. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number was not reported) 1 dosage forms, 1 total administered on 23-JUL-2021 for covid-19 vaccination. The drug start period was 51 days and drug last period was 51 days. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 11-SEP-2021, the patient experienced vaccination failure, and was hospitalized (date unspecified). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from vaccination failure. This report was serious (Hospitalization Caused / Prolonged). This case is associated with product quality complaint.

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