475-13888-92071
4 vaccinations
8 coded responses
48 check-ins
8 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 726 / AR
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-07
Dose 1 — Janssen/Johnson & Johnson
-
2021-03-08
Registered in v-safe
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2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Musculoskeletal stiffness, Sinus headache — Feeling: Fair · Muscle or body achesFree text: Sinus headache and neck stiffnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-04-12
- 2021-04-18
- 2021-06-06
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2021-09-05
Survey response — 6 months, dose 1MedDRA: Cough, Fatigue, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: post COVID fatigue,coughMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-05
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-09
Call successfulDoes not wish to fill out VAERS report
-
2021-11-02
Dose 2 — Moderna
-
2021-11-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-11-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Joint painsAdult check-in
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-16
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2021-11-23
Survey response — day 21, dose 2MedDRA: Blood pressure abnormal, Pulse abnormal, Toothache — Feeling: FairFree text: Pain in my front teeth, erratic b/p makes my nose and teeth pulsateMedDRA releases: 2024-11 · check-in free text available
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2021-11-30
Survey response — day 28, dose 2MedDRA: Cardiac assistance device user, Supraventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: My pacemaker is recording premature atrial contractions in the "thousands".MedDRA releases: 2024-11 · check-in free text available
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2021-11-30
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-12-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-07
- 2021-12-14
-
2022-02-03
Survey response — 3 months, dose 2MedDRA: Glomerular filtration rate decreased, Lung disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: x-ray revealed hyperextended lungs and my Gfr has dropped.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-03
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-04-10
Dose 3 — Moderna
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2022-04-11
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-04-12
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
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2022-04-13
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Dysgeusia — Feeling: Good · Site: Pain · Joint pains, Muscle or body achesFree text: Forgot to report in the last two days a dry cough and food tasting bad. Those have resolved.MedDRA releases: 2024-11 · check-in free text available
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2022-04-14
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Joint pains, Muscle or body achesAdult check-in
- 2022-04-15
- 2022-04-16
- 2022-04-17
- 2022-04-24
- 2022-05-01
- 2022-05-08
- 2022-05-15
- 2022-05-22
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2022-07-10
Survey response — 3 months, dose 3MedDRA: Arthralgia, Fatigue — Feeling: FairFree text: Not new but continued fatigue and joint pains.MedDRA releases: 2024-11 · check-in free text available
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2022-09-30
Dose 4 — Pfizer-BioNTechCo-administered: Flu
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2022-10-09
Survey response — 6 months, dose 3MedDRA: Ageusia, Arthralgia, Fatigue, Myalgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sore muscles and joints. Fatigue Lake of taste. Took COVID booster 9.30.22 Pfizer.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-18
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-12-30
- 2023-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-07 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-02 | Moderna | No |
| 3 | 2022-04-10 | Moderna | No |
| 4 | 2022-09-30 | Pfizer-BioNTech | Flu |
Call center
3 call center cases
3 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Sinus headache and neck stiffness
Release 9 — 6 months, dose 1
Symptoms: post COVID fatigue,cough
Release 10 — day 21, dose 2
Symptoms: Pain in my front teeth, erratic b/p makes my nose and teeth pulsate
Release 10 — day 28, dose 2
Symptoms: My pacemaker is recording premature atrial contractions in the "thousands".
Release 11 — 3 months, dose 2
Symptoms: x-ray revealed hyperextended lungs and my Gfr has dropped.
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): Forgot to report in the last two days a dry cough and food tasting bad. Those have resolved.
Release 12 — 3 months, dose 3
Symptoms: Not new but continued fatigue and joint pains.
Release 12 — 6 months, dose 3
Symptoms: Sore muscles and joints. Fatigue Lake of taste. Took COVID booster 9.30.22 Pfizer.
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 |
|---|---|---|---|---|
| SD | Ageusia | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Blood pressure abnormal | · | · | ✓ |
| SD | Cardiac assistance device user | · | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Glomerular filtration rate decreased | · | · | ✓ |
| SD | Lung disorder | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Pulse abnormal | · | · | ✓ |
| SD | Supraventricular extrasystoles | · | · | ✓ |
| SD | Toothache | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Dysgeusia | · | · | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Sinus headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release