3JR-96367-84593

2 vaccinations 8 coded responses 30 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 770 / TX
Registered: 2021-03-10

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

Timeline

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

2021-03-10
Registered in v-safe
2021-03-10
Dose 1 — Janssen/Johnson & Johnson
2021-03-10
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Menstruation irregular — Feeling: Good · Site: Pain

Free text: period started early

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-09
Survey response — 3 months, dose 1
MedDRA: Menstruation delayed — Feeling: Good

Free text: Delayed Periods.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-08
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-11-03
Dose 2 — Moderna
Co-administered: Flu
2021-11-03
Survey response — day 0, dose 2
MedDRA: Vision blurred — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: blurry vision

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: migraine

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-11-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-08
Survey response — day 35, dose 2
MedDRA: Cough — Feeling: Fair

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Survey response — day 42, dose 2
MedDRA: Cough, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cough, fever

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-05-04
Survey response — 6 months, dose 2
MedDRA: Malaise — 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 · Telehealth, virtual health, or email health consultation

Free text: Was extremely sick

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — 6 months, dose 2
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 · 1 call case(s)
2022-05-05
Call 1 — Left Voicemail
2022-11-03
Survey response — 12 months, dose 2
MedDRA: Office visit, Pregnancy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pregnancy · Healthcare visit (other): obgyn

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-04
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	2021-03-10	Janssen/Johnson & Johnson
2	2021-11-03	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-05-04	Successful 2022-11-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-03	Successful 2022-11-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): period started early

Release 8 — 3 months, dose 1

2021-06-09

Symptoms: Delayed Periods.

Release 10 — day 0, dose 2

2021-11-03

Systemic reaction (other): blurry vision

Release 10 — days 1–6 daily, dose 2

2021-11-04

Systemic reaction (other): migraine

Release 10 — day 35, dose 2

2021-12-08

Symptoms: Cough

Release 10 — day 42, dose 2

2021-12-15

Symptoms: Cough, fever

Release 11 — 6 months, dose 2

2022-05-04

Symptoms: Was extremely sick

Release 12 — 12 months, dose 2

2022-11-03

Symptoms: Pregnancy

Healthcare visit (other): obgyn

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	·	·	✓
SD	Cough	·	·	✓
SD	Malaise	·	·	✓
SD	Menstruation delayed	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Menstruation irregular	✓	✓	✓
SRO	Migraine	·	·	✓
SRO	Vision blurred	·	·	✓

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