4AC-13110-26994

2 vaccinations 9 coded responses 20 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 537 / WI
Registered: 2021-04-10

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

2021-04-07
Dose 1 — Janssen/Johnson & Johnson
2021-04-10
Registered in v-safe
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Pregnancy — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Probably not the shots fault. Im pregnant

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-16
Pregnancy registry survey
Pregnant at time of vaccination · Yes, I would like someone to contact me
2021-04-23
Survey response — day 14, dose 1
MedDRA: Dyspepsia, Headache, Pain, Pregnancy — Feeling: Fair

Free text: Headache, heartburn, body aches (pregnancy issues)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 21, single dose
Feeling: Fair

Adult check-in
2021-05-05
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 35, single dose
MedDRA: Respiratory tract congestion, Sinusitis — Feeling: Fair

Free text: Congestion thats potentially making a sinus infection. Probably caught it from my 3 year old. (He tested negative to covid this week).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 42, single dose
MedDRA: Sinusitis — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection. On antibiotics

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — day 42, single dose
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Call successful
Does not wish to fill out VAERS report
2021-07-07
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-10-06
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-26
Dose 2 — Pfizer-BioNTech
2021-11-02
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-11-09
Survey response — day 14, dose 2
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

Free text: Mild cough and congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-23
Survey response — day 28, dose 2
MedDRA: Influenza, SARS-CoV-2 test negative, Sinusitis — 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 · Outpatient clinic or urgent care clinic visit

Free text: All members of the household caught the flu last week. Tested negative for covid. I and husband are both on antibiotics for sinus infections.

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Report sent to call center — day 28, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-24
Call 1 — Left Voicemail
2021-11-30
Survey response — day 35, dose 2
MedDRA: Cough, Viral infection — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Post-viral cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-01
Call 1 — Left Voicemail
2021-12-07
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2022-01-25
Survey response — 3 months, dose 2
MedDRA: Adverse reaction, COVID-19 — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Covid infection, moderate long covid symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-26
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-26
Survey response — 6 months, dose 2
MedDRA: Iron deficiency — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Diagnosed iron deficiency

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-27
Call successful
Not applicable - Accidental Reporting
2022-10-26
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Janssen/Johnson & Johnson
2	2021-10-26	Pfizer-BioNTech	No

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-12

Systemic reaction (other): Probably not the shots fault. Im pregnant

Release 7 — day 14, dose 1

2021-04-23

Symptoms: Headache, heartburn, body aches (pregnancy issues)

Release 8 — day 35, single dose

2021-05-14

Symptoms: Congestion thats potentially making a sinus infection. Probably caught it from my 3 year old. (He tested negative to covid this week).

Release 8 — day 42, single dose

2021-05-21

Symptoms: Sinus infection. On antibiotics

Release 10 — day 14, dose 2

2021-11-09

Symptoms: Mild cough and congestion

Release 10 — day 28, dose 2

2021-11-23

Symptoms: All members of the household caught the flu last week. Tested negative for covid. I and husband are both on antibiotics for sinus infections.

Release 10 — day 35, dose 2

2021-11-30

Symptoms: Post-viral cough

Release 11 — 3 months, dose 2

2022-01-25

Symptoms: Covid infection, moderate long covid symptoms

Release 11 — 6 months, dose 2

2022-04-26

Symptoms: Diagnosed iron deficiency

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	Adverse reaction	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspepsia	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Influenza	·	·	✓
SD	Iron deficiency	·	·	✓
SD	Pain	✓	✓	✓
SD	Pregnancy	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Viral infection	·	·	✓
SRO	Pregnancy	✓	✓	✓

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