475-27760-60847
1 vaccination
4 coded responses
12 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 319 / GA
- Registered
- 2021-03-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-27
Dose 1 — Janssen/Johnson & Johnson
-
2021-03-28
Registered in v-safe
-
2021-03-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-29
-
2021-03-30
Survey response — days 1–6 daily, dose 1MedDRA: Mouth ulceration, Oropharyngeal pain — Feeling: GoodFree text: Ulcers breaking out in mouth, sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-31
- 2021-04-01
- 2021-04-05
- 2021-04-10
- 2021-04-22
-
2021-05-04
Survey response — day 35, single doseMedDRA: Pregnancy, Vaginal haemorrhage — Feeling: GoodFree text: Pregnancy bleedingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
-
2021-06-26
Survey response — 3 months, dose 1MedDRA: Abortion spontaneous, Back pain, Decreased appetite, Tremor — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I had a miscarriage. I had my Covid shot 3/27 and conceived on the 29. I had lower back pain, loss of appetite and shakiness. My baby passed on May 9, I found out on May 11 I had a missed miscarriage. I would not recommend vaccine in early pregnancyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-26
Report sent to call center — 3 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-02
-
2021-09-27
Survey response — 6 months, dose 1MedDRA: Cough, Headache, Respiratory tract congestion — Feeling: FairFree text: Cough, congestion, headacheMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-27 | Janssen/Johnson & Johnson |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-26 | Unsuccessful |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Ulcers breaking out in mouth, sore throat
Release 8 — day 35, single dose
Symptoms: Pregnancy bleeding
Release 9 — 3 months, dose 1
Symptoms: I had a miscarriage. I had my Covid shot 3/27 and conceived on the 29. I had lower back pain, loss of appetite and shakiness. My baby passed on May 9, I found out on May 11 I had a missed miscarriage. I would not recommend vaccine in early pregnancy cut off by CDC
Release 9 — 6 months, dose 1
Symptoms: Cough, congestion, headache
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 | Abortion spontaneous | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pregnancy | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Tremor | ✓ | ✓ | ✓ |
| SD | Vaginal haemorrhage | ✓ | ✓ | ✓ |
| SRO | Mouth ulceration | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release