3AK-27626-57343

4 vaccinations 15 coded responses 43 check-ins 15 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 334 / FL
Registered: 2021-03-13

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Janssen/Johnson & Johnson
2021-03-13
Survey response — day 0, dose 1
MedDRA: Anxiety, Dizziness, Hypoaesthesia oral, Immediate post-injection reaction, Medical counselling, Medical observation, Palpitations, Swollen tongue, Taste disorder — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): A little dizziness and some racing heart since coming home, could be anxiety over what happened at injection. At time of injection, i had odd taste in mouth and my tongue numbed and swelled. Pharmacist administered Benadryl and had me stay longer · Healthcare visit (other): Pharmacist administered Benadryl during wait time and had me stay longer than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — day 0, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Dysphonia, Dyspnoea, Pyrexia — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Free text: What feels like low grade fever, but dont think i have temperature. Very hoarse today and some shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Dysphonia — Feeling: Fair · Site: Redness, Itching · Fever · Headache, Fatigue or tiredness

Free text: Still hoarness in voice and some heaviness is chest with breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Dysphonia — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Still hoarseness in voice

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Call 2 — Left Voicemail
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Cough — Feeling: Fair · Site: Pain · Headache

Free text: Heaviness in chest i had been experiencing is now combined with a cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-20
Survey response — day 7, dose 1
MedDRA: Chest discomfort, Cough — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Coughing and still heaviness in chest breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-12
Survey response — 6 months, dose 1
MedDRA: Back pain, Headache, Painful respiration, Renal pain — 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, Outpatient clinic or urgent care clinic visit

Free text: Kidney pains in back, hurts when inhalingBad headaches

MedDRA releases: 2024-11 · check-in free text available
2021-09-12
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 2 — Left Voicemail
2021-10-29
Dose 2 — Pfizer-BioNTech
2021-11-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Unrelated back pain in lumbar since yesterday

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dyspnoea, Hypoaesthesia oral, Immediate post-injection reaction, Paraesthesia oral, Vaccine positive rechallenge — Feeling: Good

Free text: I received the booster on 10/29 but not asked to check in till days later. Had similar reaction with pzier booster with tingling numb tongue at time of shot along with wooziness and difficulty breathing later in day

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2021-11-05
Survey response — day 7, dose 2
MedDRA: Pruritus, Rash — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Had some rash bumps and itching on arms shoulder, not at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — day 14, dose 2
MedDRA: Burning sensation, Pruritus, Skin burning sensation — Feeling: Fair

Free text: Continually itching and burning, all over but mostly palms and scalp. Also hips, thighs and bottom of feet

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Survey response — day 21, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Same itching burning as previous

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-10
Survey response — day 42, dose 2
MedDRA: Epistaxis, Headache, Self-medication — Feeling: Fair

Free text: Severe headaches, tylenol not helping Also experienced bloody nose on/off

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2022-07-02
Dose 3 — Pfizer-BioNTech
2022-07-02
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-07-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-07-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-07-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-07-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-07-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-07-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-07-09
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-07-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-07-25
Survey response — day 21, dose 3
MedDRA: Diarrhoea, Fatigue — Feeling: Poor · Be unable to work or attend school

Free text: Severe fatigue, diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-07-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-08-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-08-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-10-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-06
Dose 4 — Pfizer-BioNTech
2022-12-31
Survey response — 6 months, dose 3
MedDRA: Bronchitis, Sinusitis — Feeling: Poor · Be unable to work or attend school, 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: Recurring Sinus infection and bronchitis since mid November

MedDRA releases: 2024-11 · check-in free text available
2022-12-31
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-06-06
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Janssen/Johnson & Johnson
2	2021-10-29	Pfizer-BioNTech	No
3	2022-07-02	Pfizer-BioNTech	No
4	2022-12-06	Pfizer-BioNTech	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-13

Systemic reaction (other): A little dizziness and some racing heart since coming home, could be anxiety over what happened at injection. At time of injection, i had odd taste in mouth and my tongue numbed and swelled. Pharmacist administered Benadryl and had me stay longer

Healthcare visit (other): Pharmacist administered Benadryl during wait time and had me stay longer than usual

Release 5 — days 1–6 daily, dose 1

2021-03-15

Systemic reaction (other): What feels like low grade fever, but dont think i have temperature. Very hoarse today and some shortness of breath

2021-03-16

Systemic reaction (other): Still hoarness in voice and some heaviness is chest with breathing

2021-03-17

Systemic reaction (other): Still hoarseness in voice

2021-03-18

Systemic reaction (other): Heaviness in chest i had been experiencing is now combined with a cough

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Coughing and still heaviness in chest breathing

Release 9 — 6 months, dose 1

2021-09-12

Symptoms: Kidney pains in back, hurts when inhalingBad headaches

Release 10 — days 1–6 daily, dose 2

2021-11-02

Systemic reaction (other): Unrelated back pain in lumbar since yesterday

2021-11-03

Systemic reaction (other): I received the booster on 10/29 but not asked to check in till days later. Had similar reaction with pzier booster with tingling numb tongue at time of shot along with wooziness and difficulty breathing later in day

Release 10 — day 7, dose 2

2021-11-05

Systemic reaction (other): Had some rash bumps and itching on arms shoulder, not at injection site

Release 10 — day 14, dose 2

2021-11-13

Symptoms: Continually itching and burning, all over but mostly palms and scalp. Also hips, thighs and bottom of feet

Release 10 — day 21, dose 2

2021-11-19

Symptoms: Same itching burning as previous

Release 10 — day 42, dose 2

2021-12-10

Symptoms: Severe headaches, tylenol not helping Also experienced bloody nose on/off

Release 12 — day 21, dose 3

2022-07-25

Symptoms: Severe fatigue, diarrhea

Release 12 — 6 months, dose 3

2022-12-31

Symptoms: Recurring Sinus infection and bronchitis since mid November

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	Medical counselling	✓	✓	✓
HCVO	Medical observation	✓	✓	✓
SD	Back pain	·	·	✓
SD	Bronchitis	·	·	✓
SD	Burning sensation	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Painful respiration	·	·	✓
SD	Pruritus	·	·	✓
SD	Renal pain	·	·	✓
SD	Self-medication	·	·	✓
SD	Sinusitis	·	·	✓
SD	Skin burning sensation	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Back pain	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysphonia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Medical counselling	✓	✓	✓
SRO	Medical observation	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Paraesthesia oral	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Swollen tongue	✓	✓	✓
SRO	Taste disorder	✓	✓	✓
SRO	Vaccine positive rechallenge	·	·	✓

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