2X9-14314-51274

3 vaccinations 5 coded responses 33 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 46-50
ZIP prefix: 727 / AR
Registered: 2021-03-11

Relationship: Self
Race: American Indian or Alaska Native
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Janssen/Johnson & Johnson
2021-03-11
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Survey response — day 14, dose 1
MedDRA: Headache, Pre-existing disease, Seasonal allergy, Sinus congestion — Feeling: Fair

Free text: Seasonal allergies are causing headache, mild sinus congestion. No symptoms clearly linked to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-15
Survey response — day 35, single dose
MedDRA: Muscular weakness, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Had severe pain and weakness in my left arm for several days, starting 4/9/2021, thru 4/13. I became very concerned as news of blood clots came out. Condition seems to have resolved over the last week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 42, single dose
Feeling: Fair

Adult check-in
2021-06-10
Health check-in — 3 months, dose 1
Feeling: Fair

Adult check-in
2021-09-09
Health check-in — 6 months, dose 1
Feeling: Fair

Adult check-in
2021-12-03
Dose 2 — Moderna
Co-administered: Flu
2021-12-03
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-12-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-12-17
Survey response — day 14, dose 2
MedDRA: Fatigue, Gastrointestinal disorder, Insomnia, Nasopharyngitis — Feeling: Fair

Free text: GI problems, tired, trouble sleeping (probably a cold that my wife had last week)

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2022-01-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-03-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-06-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-09-15
Dose 3 — Moderna
2022-10-08
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-10-13
Survey response — day 28, dose 3
MedDRA: Headache — Feeling: Good

Free text: Severe headache, near migraine intensity

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-12-15
Survey response — 3 months, dose 3
MedDRA: COVID-19, Respiratory syncytial virus infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I had Covid and RSV three weeks back

MedDRA releases: 2024-11 · check-in free text available
2022-12-15
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-16
Call 1 — Left Voicemail
2023-03-16
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Janssen/Johnson & Johnson
2	2021-12-03	Moderna	Flu
3	2022-09-15	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-03-25

Symptoms: Seasonal allergies are causing headache, mild sinus congestion. No symptoms clearly linked to the vaccine.

Release 7 — day 35, single dose

2021-04-15

Symptoms: Had severe pain and weakness in my left arm for several days, starting 4/9/2021, thru 4/13. I became very concerned as news of blood clots came out. Condition seems to have resolved over the last week.

Release 10 — day 14, dose 2

2021-12-17

Symptoms: GI problems, tired, trouble sleeping (probably a cold that my wife had last week)

Release 12 — day 28, dose 3

2022-10-13

Symptoms: Severe headache, near migraine intensity

Release 12 — 3 months, dose 3

2022-12-15

Symptoms: I had Covid and RSV three weeks back

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	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Muscular weakness	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	Seasonal allergy	○	✓	○
SD	Sinus congestion	✓	✓	✓

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