Adverse Event Reporting
| VAERS ID | 1145725 |
|---|---|
| Gender | Female |
| Age | |
| StateCode | NC |
| Pharmaceutical Company | JANSSEN |
| Lot Number | |
| Number of vaccinations | |
| Vaccinated | 2021-03-12 |
| Onset | 2021-03-12 |
| Condition | Life Threatening |
Symptoms
- Lip swelling
- Swelling face
Current Illness
2) 3)
Preexisting Conditions
Unknown
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
SWELLING OF THE UPPER LIP (Lip swelling, Lip swelling) FACIAL SWELLING (Facial swelling, Swelling face) SORE ARM (Pain in arm, Pain in extremity) This spontaneous report received from a patient (health care professional) concerned a female of unspecified age.
The patent's height, and weight were not reported.
The patient's concurrent conditions included cat allergy, food allergy, and dye allergy.
The patient received covid-19 vaccine ad26.
cov2.
s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 12-MAR-2021 10:35 for prophylactic vaccination.
The batch number was not reported and has been requested.
No concomitant medications were reported.
On 12-MAR-2021, after receiving the vaccine, the patient experienced sore arm, swelling of the upper lip and facial swelling.
The action taken with covid-19 vaccine ad26.
cov2.
s was not applicable.
The patient had not recovered from sore arm, swelling of the upper lip, and facial swelling.
This report was serious (Life Threatening) .
Version 1 created to amend previously reported information on 12-MAR-2021.
Upon review following information was amended: The events sore arm, swelling of the upper lip, and facial swelling upgraded to serious with seriousness criteria as Life threatening.