Adverse Event Reporting

VAERS ID	2227976
Gender	Female
Age	60
StateCode	FR
Pharmaceutical Company	JANSSEN
Lot Number
Number of vaccinations	1
Vaccinated
Onset
Condition	Died

Symptoms

• Fatigue

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

FATIGABILITY; This spontaneous report received from a health care professional by a Regulatory Authority (RA, PH-PHFDA-300142171) concerned a 61 year old female of unspecified race and ethnic origin.
The patient's height, and weight were not reported.
No past medical history or concurrent conditions were reported.
The patient was 60 years old at the time of vaccination.
The patient received covid-19 vaccine ad26.
cov2.
s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: UNKNOWN) dose was not reported, 1 total administered on 26-JUL-2021 for an unspecified indication.
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 experienced fatigability and died due to fatigability.
It was unknown if autopsy was performed.
The action taken with covid-19 vaccine ad26.
cov2.
s was not applicable.
This report was serious (Death).
; Sender's Comments: V0: 20220416981-COVID-19 VACCINE AD26.
COV2.
S-fatigability.
The event(s) has an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility.
There is no information on any other factors potentially associated with the event(s).
Therefore, this event(s) is considered unassessable.
; Reported Cause(s) of Death: FATIGABILITY