4T3-64597-55508

2 vaccinations 14 coded responses 30 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 325 / FL
Registered: 2021-04-09

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Janssen/Johnson & Johnson
2021-04-09
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Resting heart rate over 124 at 1:34 am.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia oral — Feeling: Fair · Headache, Joint pains, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Tongue feels like it does when I get numbed at dentist. Mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Nausea · Be unable to do your normal daily activities

Free text: Both Sunday and today, bouts of feeling lightheaded or dizzy

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 · Headache

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Decreased appetite, Nausea — Feeling: Good · Headache, Nausea

Free text: Nausea comes and goes usually after food, appetite also very low.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-10-08
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-12-30
Dose 2 — Pfizer-BioNTech
2021-12-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-12-31
Survey response — days 1–6 daily, dose 2
MedDRA: Nervous system disorder, Peripheral coldness, Sensitive skin — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Limbs are extremely cold to the touch as well as extremities are very sensitive to the touch (like nerves are very sensitive even to clothing)

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Chills, Muscle or body aches, Nausea

Free text: Throat glands swollen since last night

MedDRA releases: 2024-11 · check-in free text available
2022-01-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Nausea, Abdominal pain

Adult check-in
2022-01-03
Survey response — days 1–6 daily, dose 2
MedDRA: Thirst — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Extremely thirsty

MedDRA releases: 2024-11 · check-in free text available
2022-01-04
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Painful respiration — Feeling: Good · Site: Pain · Diarrhea

Free text: Achy chest with breathing (actually occurred since 12/30/2021 not reported)

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Nausea

Adult check-in
2022-01-06
Survey response — day 7, dose 2
MedDRA: Abdominal pain — Feeling: Fair · Fever · Headache, Nausea, Abdominal pain

Free text: Abdominal pain comes and goes but it is a powerful punching pain when it happens

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Survey response — day 14, dose 2
MedDRA: Cough, Limb mass, Lymphadenopathy, Oropharyngeal pain, Pruritus, Respiratory tract congestion, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: Arm that shot was administered had lumps under the skin that were really itchy for 4-6 days. Also, on 1/12/2022 I was diagnosed with acute upper respiratory infection (COVID test was negative). Sore throat, swollen glands, cough, and congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Survey response — day 21, dose 2
MedDRA: Bronchitis, Illness, Office visit, Respiratory disorder, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Breathing problems worsened: continued from 1/10/2022 illness that has continued and worsened from an Upper Respiratory Infection on 1/11/2022 to Acute Bronchitis on 1/18/2022 under medical care, received medications

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2022-02-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-02-10
Survey response — day 42, dose 2
MedDRA: Deafness unilateral, Office visit — Feeling: Good · Be unable to do your normal daily activities

Free text: Hearing loss in one ear (Audiologist suggested providing this on this platform). Results in that ear were +60 at 8000 Hz

MedDRA releases: 2024-11 · check-in free text available
2022-04-02
Survey response — 3 months, dose 2
MedDRA: Cough — Feeling: Fair

Free text: Consistent cough

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Survey response — 6 months, dose 2
MedDRA: Hypoacusis, Medical counselling, Respiratory tract congestion — Feeling: Fair · 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: I got booster (Pfizer) in Dec 30, 2021 & onJan 4 came down with severe respiratory infection that took me out for a month. Also have had aprox 50% reduction in hearing on same side as shot (left) may be coincidental but Dr suggested I notify you

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Report sent to call center — 6 months, 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)
2022-07-05
Call successful
Participant prefers to complete VAERS report online
2022-12-30
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Janssen/Johnson & Johnson
2	2021-12-30	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Resting heart rate over 124 at 1:34 am.

2021-04-11

Systemic reaction (other): Tongue feels like it does when I get numbed at dentist. Mild

2021-04-12

Systemic reaction (other): Both Sunday and today, bouts of feeling lightheaded or dizzy

2021-04-14

Systemic reaction (other): Nausea comes and goes usually after food, appetite also very low.

Release 10 — days 1–6 daily, dose 2

2021-12-31

Systemic reaction (other): Limbs are extremely cold to the touch as well as extremities are very sensitive to the touch (like nerves are very sensitive even to clothing)

2022-01-01

Systemic reaction (other): Throat glands swollen since last night

2022-01-03

Systemic reaction (other): Extremely thirsty

2022-01-04

Systemic reaction (other): Achy chest with breathing (actually occurred since 12/30/2021 not reported)

Release 10 — day 7, dose 2

2022-01-06

Systemic reaction (other): Abdominal pain comes and goes but it is a powerful punching pain when it happens

Release 10 — day 14, dose 2

2022-01-13

Symptoms: Arm that shot was administered had lumps under the skin that were really itchy for 4-6 days. Also, on 1/12/2022 I was diagnosed with acute upper respiratory infection (COVID test was negative). Sore throat, swollen glands, cough, and congestion.

Release 10 — day 21, dose 2

2022-01-20

Symptoms: Breathing problems worsened: continued from 1/10/2022 illness that has continued and worsened from an Upper Respiratory Infection on 1/11/2022 to Acute Bronchitis on 1/18/2022 under medical care, received medications

Release 11 — day 42, dose 2

2022-02-10

Symptoms: Hearing loss in one ear (Audiologist suggested providing this on this platform). Results in that ear were +60 at 8000 Hz

Release 11 — 3 months, dose 2

2022-04-02

Symptoms: Consistent cough

Release 12 — 6 months, dose 2

2022-07-01

Symptoms: I got booster (Pfizer) in Dec 30, 2021 & onJan 4 came down with severe respiratory infection that took me out for a month. Also have had aprox 50% reduction in hearing on same side as shot (left) may be coincidental but Dr suggested I notify you

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	Bronchitis	·	·	✓
SD	Cough	·	·	✓
SD	Deafness unilateral	·	·	✓
SD	Hypoacusis	·	·	✓
SD	Illness	·	·	✓
SD	Limb mass	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Medical counselling	·	·	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pruritus	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Abdominal pain	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Nausea	✓	✓	✓
SRO	Nervous system disorder	·	·	✓
SRO	Painful respiration	·	·	✓
SRO	Peripheral coldness	·	·	✓
SRO	Sensitive skin	·	·	✓
SRO	Thirst	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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