Adverse Event Reporting
| VAERS ID | 1842058 |
|---|---|
| Gender | Female |
| Age | |
| StateCode | |
| Pharmaceutical Company | JANSSEN |
| Lot Number | |
| Number of vaccinations | |
| Vaccinated | |
| Onset | |
| Condition | Hospitalized Died |
Symptoms
- Computerised tomogram
- Death
Current Illness
Preexisting Conditions
Medical History/Concurrent Conditions: Colon cancer stage IV (Just diagnosed w/stage 4 colon cancer that already metastasized.); Kidney stone (possible kidney stone ct of belly was clear.)
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Test Name: CT scan; Result Unstructured Data: clear; Test Name: CT scan; Result Unstructured Data: kidney stone; Comments: ct scan late 20 for possible kidney stone
Write-up
THE PATIENT DIED (THE PATIENT SURVIVED 2 WEEKS IN ICU BEFORE SHE PAST 2); This spontaneous report received from a patient via a company representative via social media concerned a 3 decade old female of unspecified race and ethnic origin.
The patient's height, and weight were not reported.
The patient's past medical history included: stage 4 colon cancer, and kidney stone.
The patient received covid-19 vaccine ad26.
cov2.
s (suspension for injection, route of admin not reported, batch number: Unknown, expiry : unknown) dose, start therapy date were not reported, 1 total, administered for prophylactic vaccination.
The batch number was not reported.
The Company is unable to perform follow-up to request batch/lot numbers.
No concomitant medications were reported.
On an unspecified date, the patient died (the patient survived 2 weeks in icu before she past 2 ) and was hospitalized in ICU (date unspecified).
Laboratory data (dates unspecified) included: CT scan (NR: not provided) kidney stone, clear.
On an unspecified date, the patient died from unknown cause of death.
It was unknown if an autopsy was performed The action taken with covid-19 vaccine ad26.
cov2.
s was not applicable.
This report was serious (Death, and Hospitalization Caused / Prolonged).
; Sender's Comments: V0: 20211104964-Covid-19 vaccine ad26.
cov2.
s - The patient died (the patient survived 2 weeks in icu before she past 2 ).
This event(s) is considered unassessable.
The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility.
There is no information on any other factors potentially associated with the event(s).
; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH