44S-27320-32106

4 vaccinations 7 coded responses 35 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 064 / CT
Registered: 2021-03-21

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

2021-03-20
Dose 1 — Janssen/Johnson & Johnson
2021-03-21
Registered in v-safe
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Self-medication — Feeling: Good

Free text: No but I took one Benadryl on day 1 and now I am worried that this will reduce immune response of vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Survey response — day 7, dose 1
MedDRA: Throat irritation — Feeling: Fair

Free text: Scratchy throat

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

Adult check-in
2021-04-10
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-19
Survey response — 3 months, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Lichen sclerosus-inflammatory

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-19
Report sent to call center — 3 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call 1 — Left Voicemail
2021-09-18
Survey response — 6 months, dose 1
MedDRA: Hepatic enzyme increased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Elevated liver enzymes.

MedDRA releases: 2024-11 · check-in free text available
2021-09-18
Report sent to call center — 6 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-21
Call successful
Does not wish to fill out VAERS report
2021-10-31
Dose 2 — Moderna
2021-11-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-11-07
Health check-in — day 7, dose 2
Feeling: Good · None

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

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

Adult check-in
2021-11-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-02
Dose 3 — Moderna
2022-05-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-09-20
Dose 4 — Moderna
2022-10-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-18
Survey response — day 28, dose 4
MedDRA: Cough, Pain, SARS-CoV-2 test negative — Feeling: Fair

Free text: Recently traveled to Englandfor 5 day trip- returned 2 days ago and have a cough and body aches. Had a negative rapid Covid test at home but going for PCR today.

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-01
Survey response — day 42, dose 4
MedDRA: Cough, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Fair

Free text: Sore throat and cough- had Covid PCR test on 10/31/22 and result was negative

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Survey response — 3 months, dose 4
MedDRA: Office visit, Respiratory tract infection, SARS-CoV-2 test negative — 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: Symptoms: Respiratory infection. Neg Covid PCR. Doctor thought possible flu. Had flu vaccination early October 2022. · Healthcare visit (other): Outpatient PCR test

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Report sent to call center — 3 months, dose 4
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)
2022-12-21
Call successful
Not applicable - Accidental Reporting
2023-03-21
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Janssen/Johnson & Johnson
2	2021-10-31	Moderna	No
3	2022-04-02	Moderna	No
4	2022-09-20	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): No but I took one Benadryl on day 1 and now I am worried that this will reduce immune response of vaccination.

Release 6 — day 7, dose 1

2021-03-27

Systemic reaction (other): Scratchy throat

Release 9 — 3 months, dose 1

2021-06-19

Symptoms: Lichen sclerosus-inflammatory

Release 9 — 6 months, dose 1

2021-09-18

Symptoms: Elevated liver enzymes.

Release 12 — day 28, dose 4

2022-10-18

Symptoms: Recently traveled to Englandfor 5 day trip- returned 2 days ago and have a cough and body aches. Had a negative rapid Covid test at home but going for PCR today.

Release 12 — day 42, dose 4

2022-11-01

Symptoms: Sore throat and cough- had Covid PCR test on 10/31/22 and result was negative

Release 12 — 3 months, dose 4

2022-12-20

Symptoms: Respiratory infection. Neg Covid PCR. Doctor thought possible flu. Had flu vaccination early October 2022.

Healthcare visit (other): Outpatient PCR test

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	Hepatic enzyme increased	·	·	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract infection	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Self-medication	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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