이상반응 보고
| VAERS ID | 1319778 |
|---|---|
| 성별 | 여성 |
| 나이 | 66세 |
| 주 코드 | VA |
| 제약회사 | JANSSEN |
| 로트 번호 | 202A21A |
| 예방접종 횟수 | |
| 접종일 | |
| 발병일 | 2021-04-28 |
| 상태 | 사망 |
증상
- 실험실 테스트(Laboratory test)
- 혈전증(Thrombosis)
- 죽음(Death)
이환 중 질병
Abstains from alcohol; Blood pressure high; Diabetes; High cholesterol; Non-smoker
지병
Comments: The patient had no known allergies, no drug abuse or illicit drug use.
기타 의료
이전 예방접종
알레르기
임상 검사
Test Name: Laboratory test; Result Unstructured Data: Unknown; Comments: Done 3-4 months ago (results of which were unavailable at that time)
증상 상세
DEATH; BLOOD CLOT; This spontaneous report received from a health care professional concerned a 66 year old White and not Hispanic or Latino female.
Initial information received from the health care professional on 05-MAY-2021 was processed with additional information obtained from live follow up with health care professional on 06-MAY-2021.
The patient's height, and weight were not reported.
The patient's concurrent conditions included high blood pressure, diabetes, high cholesterol, non smoker, non alcohol user and other pre-existing medical conditions included no known allergies, no drug abuse or illicit drug use.
Lab work was done 3-4 months ago, the results of which were unavailable.
The patient received covid-19 vaccine ad26.
cov2.
s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: Unknown) dose was not reported, 1 total, administered on 10-APR-2021 possibly left arm for prophylactic vaccination.
Unspecified concomitant medications were reported.
On 28-APR-2021, the patient developed right leg pain and right leg swelling also began around this time as well.
On 04-MAY-2021, the patient died from blood clot.
An autopsy was not performed.
The reporter stated that the patient's death was related to Janssen covid-19 vaccination and blood clots.
The action taken with covid-19 vaccine ad26.
cov2.
s was not applicable.
The patient died of blood clot on 04-MAY-2021.
This report was serious (Death).
; Sender's Comments: V0:20210509157-JANSSEN COVID-19 VACCINE- Death, blood clot - These events are considered unassessable.
The events have a compatible/suggestive temporal relationship, are unlabeled, and have unknown scientific plausibility.
There is no information on any other factors potentially associated with the events.
; Reported Cause(s) of Death: BLOOD CLOT