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

This is VAERS ID 1770414

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Case Details

VAERS ID: 1770414 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-10-05
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211005; Test Name: Antibody test; Result Unstructured Data: Negative, No antibodies.
CDC Split Type: USJNJFOC20211011984

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned an 87 year old White and Non Hispanic or Latino female. 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: 1805029 and expiry: UNKNOWN) 1 total, dose was not reported, administered at right arm on 17-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. Patient needed a blood test after she was vaccinated and patient asked the doctor to check for antibodies against covid-19. On 05-OCT-2021, it was reported that patient had less than 1 %, that means patient had no antibodies (Confirmed immunological vaccine failure). Laboratory data (dates unspecified) included: Antibody test (NR: not provided) Negative, Less than 1% (No antibodies). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000196260.; Sender''s Comments: V0:20211011984-covid-19 vaccine ad26.cov2.s-confirmed immunological vaccine failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


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