437-63024-65970

2 vaccinations 5 coded responses 31 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 607 / IL
Registered: 2021-03-10

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

2021-03-10
Registered in v-safe
2021-03-10
Dose 1 — Janssen/Johnson & Johnson
2021-03-10
Health check-in — day 0, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Headache 6/10 started 6 pm yesterday and all night and morning today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

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

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

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: Fair

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

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

Adult check-in
2021-06-10
Survey response — 3 months, dose 1
MedDRA: Pain, Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Itchy, painful lesions appearing 14 days ago on right leg (10), 1 on left, now fading.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-21
Call 2 — Left Voicemail
2021-09-08
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-11-27
Dose 2 — Pfizer-BioNTech
2021-11-27
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness

Free text: Just got the vaccine at 9 am. It's 4 pm now.

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-12-04
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-12-11
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-12-18
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-12-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2022-01-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2022-01-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2022-02-26
Survey response — 3 months, dose 2
MedDRA: Office visit, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: More aches and pains. · Healthcare visit (other): Regular 3 month checkups. Age 87.

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-04
Call 1 — Left Voicemail
2022-05-28
Survey response — 6 months, dose 2
MedDRA: Extrasystoles, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Ectopic beats · Healthcare visit (other): Routine ffice follow up

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-31
Call 1 — Left Voicemail
2022-05-31
Call 2 — Left Voicemail
2022-05-31
Call 1 — Left Voicemail
2022-11-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Janssen/Johnson & Johnson
2	2021-11-27	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-10	Unsuccessful
2022-02-26	Unsuccessful
2022-05-28	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): Headache 6/10 started 6 pm yesterday and all night and morning today

Release 9 — 3 months, dose 1

2021-06-10

Symptoms: Itchy, painful lesions appearing 14 days ago on right leg (10), 1 on left, now fading.

Release 10 — day 0, dose 2

2021-11-27

Systemic reaction (other): Just got the vaccine at 9 am. It's 4 pm now.

Release 11 — 3 months, dose 2

2022-02-26

Symptoms: More aches and pains.

Healthcare visit (other): Regular 3 month checkups. Age 87.

Release 11 — 6 months, dose 2

2022-05-28

Symptoms: Ectopic beats

Healthcare visit (other): Routine ffice follow up

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	Extrasystoles	·	·	✓
SD	Pain	✓	✓	✓
SD	Pruritus	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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