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|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN||- / UNK||- / -|
Administered by: Other Purchased by: ??
Symptoms: Vaccination failure
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:
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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