3GM-23735-14802

3 vaccinations 6 coded responses 30 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 610 / IL
Registered: 2021-04-28

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

2021-04-28
Registered in v-safe
2021-04-28
Dose 1 — Janssen/Johnson & Johnson
2021-04-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-29
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I just have zero energy!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Diarrhea, Abdominal pain

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-26
Survey response — day 28, single dose
MedDRA: Cholecystectomy, Diarrhoea, Gastrointestinal disorder, Headache, Migraine, Musculoskeletal chest pain, Oropharyngeal pain, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat, worst headache of my life and Ive suffered through many migraines in my life. GI issues pain at bottom of my rib cage (if I didnt have my gallbladder removed already, I wouldve thought it was that). Diarrhea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 35, single dose
Feeling: Fair

Adult check-in
2021-06-09
Health check-in — day 42, single dose
Feeling: Fair

Adult check-in
2021-07-28
Survey response — 3 months, dose 1
MedDRA: Abdominal discomfort, Headache, Lethargy, Syncope — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Extreme lethargyHeadaches Syncope GI upset

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-28
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Call 1 — Left Voicemail
2021-10-27
Survey response — 6 months, dose 1
MedDRA: Cough, Dyspnoea, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Shortness of breath and cough without exertion. · Healthcare visit (other): Chest X-ray, PFT's, and hi def CT of lungs

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Report sent to call center — 6 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-28
Call 1 — Could Not Reach Participant
2021-11-02
Call 2 — Could Not Reach Participant
2021-11-19
Dose 2 — Moderna
2022-04-28
Survey response — 12 months, dose 1
MedDRA: Office visit, Oxygen saturation decreased, Sciatica — 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 · Emergency room or emergency department visit

Free text: Symptoms: Sciatica (twice). Low O2 sat when sleeping · Healthcare visit (other): Spine Clinic

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — 12 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-04-29
Call 1 — Left Voicemail
2022-10-21
Dose 3 — Moderna
2022-10-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-10-28
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-11-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-11-18
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-12-02
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2023-01-22
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2023-04-21
Survey response — 6 months, dose 3
MedDRA: Pleural effusion, Pneumonia aspiration — 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 visit, Hospitalization

MedDRA releases: 2024-11
2023-04-21
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-04-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-28	Janssen/Johnson & Johnson
2	2021-11-19	Moderna	No
3	2022-10-21	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 1

2021-04-29

Systemic reaction (other): I just have zero energy!

Release 8 — day 28, single dose

2021-05-26

Symptoms: Sore throat, worst headache of my life and Ive suffered through many migraines in my life. GI issues pain at bottom of my rib cage (if I didnt have my gallbladder removed already, I wouldve thought it was that). Diarrhea.

Release 9 — 3 months, dose 1

2021-07-28

Symptoms: Extreme lethargyHeadaches Syncope GI upset

Release 10 — 6 months, dose 1

2021-10-27

Symptoms: Shortness of breath and cough without exertion.

Healthcare visit (other): Chest X-ray, PFT's, and hi def CT of lungs

Release 11 — 12 months, dose 1

2022-04-28

Symptoms: Sciatica (twice). Low O2 sat when sleeping

Healthcare visit (other): Spine Clinic

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	Abdominal discomfort	✓	·	✓
SD	Cholecystectomy	✓	✓	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Lethargy	✓	·	✓
SD	Migraine	✓	✓	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Oxygen saturation decreased	·	·	✓
SD	Pleural effusion	·	·	✓
SD	Pneumonia aspiration	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sciatica	·	·	✓
SD	Syncope	✓	·	✓
SRO	Asthenia	✓	✓	✓

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