3MD-94741-19923
3 vaccinations
2 coded responses
31 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 201 / VA
- Registered
- 2021-04-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-09
Registered in v-safe
-
2021-04-09
Dose 1 — Janssen/Johnson & Johnson
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
-
2021-04-14
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Diarrhea, Abdominal painAdult check-in
- 2021-04-15
- 2021-04-16
-
2021-04-23
Survey response — day 14, dose 1MedDRA: Exfoliative rash, Rash, Rash erythematous, Rash pruritic, Skin exfoliation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: 7 days after receiving the J&J one dose vaccine, I developed a rash on one side of my face. I've had it for 7 days w/o improvement. Red, flat, scaly, peeling, itchy, no pain. No rash history. Incidentally, I am currently being evaluated for cancer.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-01
- 2021-05-09
- 2021-05-14
- 2021-05-20
- 2021-05-21
- 2021-05-24
-
2021-05-24
Call successfulParticipant prefers to complete VAERS report online
- 2021-07-09
-
2021-10-09
Survey response — 6 months, dose 1MedDRA: Carcinoid syndrome, Neoplasm malignant, Neuroendocrine tumour, Unevaluable event — 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 visitFree text: Symptoms: Working diagnosis of Carcinoid Syndrome; other neuroendocrine tumor related conditions, including malignancy, remain on the differential. · Healthcare visit (other): Accepted as a patient by (b)(6)MedDRA releases: 2024-11 · check-in free text available
-
2021-10-09
Report sent to call center — 6 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 prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-13
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-16
Dose 2 — Janssen/Johnson & Johnson
- 2022-04-11
-
2022-10-20
Dose 3 — ModernaCo-administered: Flu
-
2022-10-20
Health check-in — day 0, dose 3Feeling: Good · Site: Pain · Fever · Chills, HeadacheAdult check-in
-
2022-10-21
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-10-22
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-23
- 2022-10-24
-
2022-10-25
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend schoolAdult check-in
-
2022-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend schoolAdult check-in
-
2022-10-27
Health check-in — day 7, dose 3Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend schoolAdult check-in
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2022-11-24
- 2022-12-01
- 2023-01-19
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-09 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-16 | Janssen/Johnson & Johnson | No |
| 3 | 2022-10-20 | Moderna | Flu |
Call center
2 call center cases
2 successful
Free text
Release 7 — day 14, dose 1
Symptoms: 7 days after receiving the J&J one dose vaccine, I developed a rash on one side of my face. I've had it for 7 days w/o improvement. Red, flat, scaly, peeling, itchy, no pain. No rash history. Incidentally, I am currently being evaluated for cancer. cut off by CDC
Release 10 — 6 months, dose 1
Symptoms: Working diagnosis of Carcinoid Syndrome; other neuroendocrine tumor related conditions, including malignancy, remain on the differential.
Healthcare visit (other): Accepted as a patient by (b)(6)
redacted (b)(6)
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 | Carcinoid syndrome | · | · | ✓ |
| SD | Exfoliative rash | ✓ | ✓ | ✓ |
| SD | Neoplasm malignant | · | · | ✓ |
| SD | Neuroendocrine tumour | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash erythematous | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Skin exfoliation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release