이상반응 보고

VAERS ID	1304956
성별	남성
나이	42세
주 코드
제약회사	JANSSEN
로트 번호
예방접종 횟수
접종일
발병일
상태	사망

증상

• 혈전증(Thrombosis)

이환 중 질병

지병

Comments: Unknown

기타 의료

이전 예방접종

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임상 검사

증상 상세

BLOOD CLOT; This spontaneous report received from a company representative concerned a 42 year old male.
The patient's weight, height, and medical history were not reported.
The patient received covid-19 vaccine ad26.
cov2.
s (suspension for injection, route of admin not reported, batch number and expiry were unknown) dose, 1 total, start therapy date were not reported for prophylactic vaccination.
The batch number was not reported and has been requested.
No concomitant medications were reported.
On an unspecified date, between three to ten days later after vaccination the patient died due to blood clots.
It was unknown, whether autopsy was performed or not.
The action taken with covid-19 vaccine ad26.
cov2.
s was not applicable.
This report was serious (Death).
; Sender's Comments: V0;20210510772-covid-19 vaccine ad26.
cov2.
s-Thrombosis.
This event(s) is considered unassessable.
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).
; Reported Cause(s) of Death: BLOOD CLOT