378-15230-43311
1 vaccination
6 coded responses
16 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 923 / CA
- Registered
- 2021-04-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-10
Registered in v-safe
-
2021-04-10
Dose 1 — Janssen/Johnson & Johnson
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2021-04-10
Survey response — day 0, dose 1MedDRA: Swelling of eyelid, Vision blurred — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: Blurred vision in right eye and mild swelling to right upper/lower eye lidMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-11
Survey response — days 1–6 daily, dose 1MedDRA: Eye pain, Eye swelling — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Right eye swelling and right eye painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
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2021-04-13
Survey response — days 1–6 daily, dose 1MedDRA: Eye swelling, Vision blurred — Feeling: Good · Site: Pain, RednessFree text: Blurred vision and mild swelling in my right eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-15
- 2021-04-16
-
2021-04-17
Health check-in — day 7, dose 1Feeling: Good · Fatigue or tiredness, Nausea, DiarrheaAdult check-in
- 2021-04-24
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2021-05-01
Survey response — day 21, single doseMedDRA: Nausea — Feeling: FairFree text: Slight Nausea almost every day since shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-07-10
-
2021-10-09
Survey response — 6 months, dose 1MedDRA: Brain fog, Periorbital swelling — Feeling: FairFree text: Brain fog and under eye puffinessMedDRA releases: 2024-11 · check-in free text available
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2022-04-10
Survey response — 12 months, dose 1MedDRA: Hyperemesis gravidarum — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I'm pregnant and have hypermesis gravidarumMedDRA releases: 2024-11 · check-in free text available
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2022-04-10
Report sent to call center — 12 months, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
-
2022-04-14
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-10 | Janssen/Johnson & Johnson |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-10 | Successful 2022-04-14 |
Completed over the phone |
Free text
Release 7 — day 0, dose 1
Systemic reaction (other): Blurred vision in right eye and mild swelling to right upper/lower eye lid
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Right eye swelling and right eye pain
Systemic reaction (other): Blurred vision and mild swelling in my right eye
Release 8 — day 21, single dose
Symptoms: Slight Nausea almost every day since shot
Release 10 — 6 months, dose 1
Symptoms: Brain fog and under eye puffiness
Release 11 — 12 months, dose 1
Symptoms: I'm pregnant and have hypermesis gravidarum
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 | Brain fog | · | · | ✓ |
| SD | Hyperemesis gravidarum | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Periorbital swelling | · | · | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Eye swelling | ✓ | ✓ | ✓ |
| SRO | Swelling of eyelid | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release