VAERS ID: |
1099241 (history) |
Form: |
Version 2.0 |
Age: |
1.33 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 2021-03-10 |
Onset: | 2021-03-11 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
- / UNK |
- / - |
Administered by: Private Purchased by: ? Symptoms: Exposure via breast milk,
Haemolytic anaemia,
Jaundice SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Haemolytic disorders (narrow), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Neonatal exposures via breast milk (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: CDC Split Type:
Write-up: Patient is breastfed by mother, who was vaccinated on 3/10. Patient developed jaundice 3/11, and was admitted for evaluation of hemolytic anemia. Evaluation ongoing. Likely not related to vaccine, but occurred within 2 days of possible to vaccine components via breastmilk |