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This is VAERS ID 1742410

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First Appeared on 10/1/2021

VAERS ID: 1742410
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Vaccination failure

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? 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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