2TG-17700-30452

3 vaccinations 6 coded responses 23 check-ins 6 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 902 / CA
Registered: 2021-04-01

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Janssen/Johnson & Johnson
2021-04-01
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-15
Survey response — day 14, dose 1
MedDRA: Eye swelling, Lip swelling, Rash, Swelling face, Unevaluable event, Urticaria — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Swelling in my face, my eyes, my lips- rash all over, hives. · Healthcare visit (other): Made dr appt for monday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — day 21, single dose
MedDRA: Office visit, Rash, Swelling, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Swelling, rash, hives. · Healthcare visit (other): Doctors office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 21, single dose
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Survey response — day 28, single dose
MedDRA: Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: The hives spread from my face to my chest. Just came off of 12 days or prednisone. last 7 days 40 mg per day. The doctor said that I will not be able to receive a Johnson & Johnson booster if needed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 28, single dose
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-05-20
Call 1 — Left Voicemail
2021-05-25
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-07-01
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-10-03
Health check-in — 6 months, dose 1
Feeling: Fair

Adult check-in
2021-10-24
Dose 2 — Moderna
2022-04-03
Survey response — 12 months, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: allergies

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Report sent to call center — 12 months, dose 1
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-06
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-12
Dose 3 — Moderna
2022-04-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-27
Survey response — day 14, dose 3
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: For the first time in my life I experienced severe allergies.

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-28
Call 1 — Left Voicemail
2022-05-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-14
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Janssen/Johnson & Johnson
2	2021-10-24	Moderna	No
3	2022-04-12	Moderna	No

Call center

5 call center cases

4 successful · 1 unsuccessful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-04

Systemic reaction (other): Diarrhea last night

Release 7 — day 14, dose 1

2021-04-15

Symptoms: Swelling in my face, my eyes, my lips- rash all over, hives.

Healthcare visit (other): Made dr appt for monday

Release 7 — day 21, single dose

2021-04-22

Symptoms: Swelling, rash, hives.

Healthcare visit (other): Doctors office visit

Release 8 — day 28, single dose

2021-04-29

Symptoms: The hives spread from my face to my chest. Just came off of 12 days or prednisone. last 7 days 40 mg per day. The doctor said that I will not be able to receive a Johnson & Johnson booster if needed.

Release 11 — 12 months, dose 1

2022-04-03

Symptoms: allergies

Release 11 — day 14, dose 3

2022-04-27

Symptoms: For the first time in my life I experienced severe allergies.

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
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Eye swelling	✓	✓	✓
SD	Lip swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Swelling face	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release