33C-85140-90888

2 vaccinations 8 coded responses 25 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 913 / CA
Registered: 2021-03-09

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

Timeline

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Janssen/Johnson & Johnson
2021-03-09
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Hard to separate from allergy symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea, Seasonal allergy, Sneezing — Feeling: Good

Free text: Sneezing, runny nose, hayfever like symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — day 7, dose 1
MedDRA: Rhinorrhoea, Sneezing — Feeling: Fair

Free text: Sniffling, runny nose, sneezing, worse than usual this time of year.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 14, dose 1
MedDRA: Hypersensitivity — Feeling: Fair

Free text: Severe allergy symptoms exacerbated by wind.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-06
Survey response — day 28, single dose
MedDRA: Seasonal allergy — Feeling: Good

Free text: Occasional very bad hayfever. There are good years and bad and this is definitely one of the bads. Absolutely no Ill effects from vaccine that I can see. Wondering if I will need a booster sooner than most.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — day 35, single dose
Feeling: Fair

Adult check-in
2021-04-20
Health check-in — day 42, single dose
Feeling: Fair

Adult check-in
2021-06-08
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-09
Survey response — 6 months, dose 1
MedDRA: Arthritis, Spondylitis — 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, Outpatient clinic or urgent care clinic visit

Free text: Crippling arthritis in my knee and back.

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-13
Call successful
Participant prefers to complete VAERS report online
2021-10-30
Dose 2 — Moderna
2021-11-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea · Be unable to work or attend school

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains

Adult check-in
2021-11-13
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-11-20
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-11-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-12-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-11
Survey response — day 42, dose 2
MedDRA: Arthralgia, Back pain, Unevaluable event — 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: Symptoms: Severe joint pain - knee, lumbar, neck. · Healthcare visit (other): MRI

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Report sent to call center — day 42, dose 2
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)
2021-12-14
Call 1 — Left Voicemail
2021-12-20
Call 2 — Left Voicemail
2022-01-29
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-04-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Janssen/Johnson & Johnson
2	2021-10-30	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Hard to separate from allergy symptoms

2021-03-11

Systemic reaction (other): None

2021-03-12

Systemic reaction (other): Sneezing, runny nose, hayfever like symptoms.

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): Sniffling, runny nose, sneezing, worse than usual this time of year.

Release 6 — day 14, dose 1

2021-03-23

Symptoms: Severe allergy symptoms exacerbated by wind.

Release 7 — day 28, single dose

2021-04-06

Symptoms: Occasional very bad hayfever. There are good years and bad and this is definitely one of the bads. Absolutely no Ill effects from vaccine that I can see. Wondering if I will need a booster sooner than most.

Release 9 — 6 months, dose 1

2021-09-09

Symptoms: Crippling arthritis in my knee and back.

Release 10 — day 42, dose 2

2021-12-11

Symptoms: Severe joint pain - knee, lumbar, neck.

Healthcare visit (other): MRI

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	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Arthritis	·	·	✓
SD	Back pain	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Seasonal allergy	✓	✓	✓
SD	Spondylitis	·	·	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Sneezing	✓	✓	✓

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