4MM-12099-81287

3 vaccinations 8 coded responses 33 check-ins 6 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 217 / MD
Registered: 2021-04-01

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Janssen/Johnson & Johnson
2021-04-01
Survey response — day 0, dose 1
MedDRA: Ear discomfort — Feeling: Good

Free text: My ear above the arm where I got the shot seemed a little clogged, but Im not sure its related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-22
Survey response — day 21, single dose
MedDRA: Back pain, Lymph node pain — Feeling: Fair

Free text: Possible kidney stone & associated back pain, but Im not sure its related. I also failed to mention earlier that my underarm lymph node near where I got the shot was sore a day afterward, but I didnt connect it at the time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-13
Survey response — day 42, single dose
MedDRA: Rash, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Basal cell carcinoma on nose (likely unrelated) and hives or poison ivy rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 42, single dose
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-30
Call 2 — Could Not Reach Participant
2021-06-09
Call 3 — Left Voicemail
2021-07-01
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-29
Dose 2 — Moderna
2021-11-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

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

Adult check-in
2021-11-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-10-29
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities

Free text: Had COVID in late July/early August 2022.

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Dose 3 — Pfizer-BioNTech
2022-12-12
Survey response — day 28, dose 3
MedDRA: Fatigue, Lethargy — Feeling: Fair

Free text: Additional lethargy; quite tired much of the time.

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-12-20
Survey response — day 42, dose 3
MedDRA: Back pain, Pain in extremity — Feeling: Fair

Free text: Perhaps unrelated, but back pain and leg pain.

MedDRA releases: 2024-11 · check-in free text available
2023-02-07
Survey response — 3 months, dose 3
MedDRA: Back pain, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-02-07
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-08
Call 1 — Left Voicemail
2023-02-08
Call 1 — Left Voicemail
2023-02-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-02-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-09
Survey response — 6 months, dose 3
MedDRA: Conjunctivitis, Viral infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-09
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-10
Call 1 — Left Voicemail
2023-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Janssen/Johnson & Johnson
2	2021-10-29	Moderna	No
3	2022-11-08	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-04-01

Systemic reaction (other): My ear above the arm where I got the shot seemed a little clogged, but Im not sure its related.

Release 7 — day 21, single dose

2021-04-22

Symptoms: Possible kidney stone & associated back pain, but Im not sure its related. I also failed to mention earlier that my underarm lymph node near where I got the shot was sore a day afterward, but I didnt connect it at the time.

Release 8 — day 42, single dose

2021-05-13

Symptoms: Basal cell carcinoma on nose (likely unrelated) and hives or poison ivy rash.

Release 12 — 12 months, dose 2

2022-10-29

Symptoms: Had COVID in late July/early August 2022.

Release 12 — day 28, dose 3

2022-12-12

Symptoms: Additional lethargy; quite tired much of the time.

Release 12 — day 42, dose 3

2022-12-20

Symptoms: Perhaps unrelated, but back pain and leg pain.

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	Back pain	·	·	✓
HCVO	Physiotherapy	·	·	✓
SD	Back pain	✓	✓	✓
SD	Conjunctivitis	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Lethargy	·	·	✓
SD	Lymph node pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Rash	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Viral infection	·	·	✓
SRO	Ear discomfort	✓	✓	✓

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