279-30305-14601
4 vaccinations
10 coded responses
55 check-ins
10 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 601 / IL
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- N/A
Timeline
-
2021-04-08
Registered in v-safe
-
2021-04-08
Dose 1 — Janssen/Johnson & Johnson
- 2021-04-08
-
2021-04-09
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-10
- 2021-04-11
- 2021-04-12
-
2021-04-13
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Throat felt a little soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-07-08
- 2021-10-07
-
2021-10-25
Dose 2 — Moderna
-
2021-10-26
Survey response — days 1–6 daily, dose 2MedDRA: Bradyphrenia, Thinking abnormal — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: My thoughts felt cloudy last night and they're a little sluggish today.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
-
2021-11-29
Survey response — day 35, dose 2MedDRA: Haemorrhoids, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Hemorrhoids. Usually I get them from changes in diet, but these were unexpected and worse than usual.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-29
Report sent to call center — day 35, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-30
-
2021-12-02
Callback requested for04:00PM ET
-
2021-12-02
Call successfulParticipant prefers to complete VAERS report online
- 2021-12-06
-
2022-01-24
Survey response — 3 months, dose 2MedDRA: COVID-19, Cough, Fatigue, Pyrexia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I was diagnosed with COVID in Dec 19, 2021. I had a fever. Coughing. Exhaustion. I don't remember what else since it was a month ago.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-25
-
2022-05-26
Dose 3 — Moderna
-
2022-05-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-29
- 2022-05-30
- 2022-05-31
-
2022-06-01
Survey response — days 1–6 daily, dose 3MedDRA: Disorientation, Disturbance in attention, Feeling abnormal — Feeling: GoodFree text: Disorientation, fuzzy headed, lack of focusMedDRA releases: 2024-11 · check-in free text available
- 2022-06-02
- 2022-06-09
- 2022-06-16
-
2022-06-23
Survey response — day 28, dose 3MedDRA: Disturbance in attention, Fatigue — Feeling: GoodFree text: Not new, but I tend to get tired and have difficulty focusing more than I used to.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-30
- 2022-07-07
- 2022-08-25
-
2022-09-22
Dose 4 — Pfizer-BioNTechCo-administered: Flu
-
2022-09-23
Survey response — days 1–6 daily, dose 4MedDRA: Brain fog, Disorientation — Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Disorientation, cloudy thinkingMedDRA releases: 2024-11 · check-in free text available
- 2022-09-24
-
2022-09-25
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-09-26
- 2022-09-27
-
2022-09-28
Survey response — days 1–6 daily, dose 4MedDRA: Brain fog — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Foggy brain has not gone away since this vaccinationMedDRA releases: 2024-11 · check-in free text available
-
2022-09-29
Survey response — day 7, dose 4MedDRA: Brain fog — Feeling: GoodFree text: Brain fog continuesMedDRA releases: 2024-11 · check-in free text available
- 2022-10-06
- 2022-10-13
- 2022-10-20
-
2022-10-27
Survey response — day 35, dose 4MedDRA: Chills, Cough, Pyrexia, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to work or attend schoolFree text: Runny nose, cough, fever, sneezing, chillsMedDRA releases: 2024-11 · check-in free text available
- 2022-11-03
- 2022-12-22
- 2023-03-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-25 | Moderna | No |
| 3 | 2022-05-26 | Moderna | No |
| 4 | 2022-09-22 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Throat felt a little sore
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): My thoughts felt cloudy last night and they're a little sluggish today.
Release 10 — day 35, dose 2
Symptoms: Hemorrhoids. Usually I get them from changes in diet, but these were unexpected and worse than usual.
Release 11 — 3 months, dose 2
Symptoms: I was diagnosed with COVID in Dec 19, 2021. I had a fever. Coughing. Exhaustion. I don't remember what else since it was a month ago.
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): Disorientation, fuzzy headed, lack of focus
Release 12 — day 28, dose 3
Symptoms: Not new, but I tend to get tired and have difficulty focusing more than I used to.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Disorientation, cloudy thinking
Systemic reaction (other): Foggy brain has not gone away since this vaccination
Release 12 — day 7, dose 4
Systemic reaction (other): Brain fog continues
Release 12 — day 35, dose 4
Symptoms: Runny nose, cough, fever, sneezing, chills
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Disturbance in attention | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Haemorrhoids | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Bradyphrenia | · | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Disorientation | · | · | ✓ |
| SRO | Disturbance in attention | · | · | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Thinking abnormal | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release