4XA-10899-77252

4 vaccinations 16 coded responses 47 check-ins 16 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 750 / TX
Registered: 2021-03-05

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Janssen/Johnson & Johnson
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Cold sweat — Feeling: Good · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: cold sweat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Chills, Fatigue or tiredness

Free text: just 2 hours in morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 7, dose 1
MedDRA: Musculoskeletal stiffness — Feeling: Good · Muscle or body aches

Free text: might have slept in wrong position; but had right side muscle stiffness in neck ; better after applying muscle cream

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 28, single dose
MedDRA: Headache, Self-medication — Feeling: Good

Free text: 2 days headache, tylenol not helping, today gone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-04-16
Survey response — day 42, single dose
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: 3 days of severe headaches (no migraine) , feels like crane is too small

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Survey response — 3 months, dose 1
MedDRA: Cardiovascular insufficiency, Headache, Pain in extremity, Poor peripheral circulation, Thinking abnormal — Feeling: Good

Free text: Mild headachesPain in left leg , poor blood circulation in upper thighLasted approximately 1,5 week and now 1 week full clear again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-03
Survey response — 6 months, dose 1
MedDRA: Temporomandibular joint syndrome — Feeling: Good

Free text: Jaw joint stressed

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-06
Dose 2 — Pfizer-BioNTech
2021-11-07
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Myalgia — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: The muscle and joint pain goes from top of schoulder downwards to elbow and moving more downwards and intenser on Sunday

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-11-10
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Fair · Site: Pain

Free text: sore injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-13
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-11-28
Survey response — day 21, dose 2
MedDRA: Gastrointestinal disorder, Malaise, Musculoskeletal stiffness, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: 2-3 days this week of a stiff painful neck and feeling ill and intestinal issues, no fever though.

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-16
Survey response — day 35, dose 2
MedDRA: Dizziness postural, Headache, Nausea, Neck pain, Tinnitus — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Since return from Belize flight on 12/15 Headache, neck pain, chirping in ear, dizziness and nausea on head-movement

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Health check-in — day 42, dose 2
Feeling: Poor

Adult check-in
2022-02-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-05-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-06-15
Dose 3 — Pfizer-BioNTech
2022-06-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-06-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-06-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-06-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-06-22
Health check-in — day 7, dose 3
Feeling: Good · Headache

Adult check-in
2022-06-29
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-07-06
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-07-13
Survey response — day 28, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe headaches started again last Friday and ongoing

MedDRA releases: 2024-11 · check-in free text available
2022-07-20
Survey response — day 35, dose 3
MedDRA: Fall, Ligament sprain, Lower limb fracture, Shock — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Busted knee and twisted ankle after a fall on the concrete backyard as unbalanced. Had medical shock as well and vitals only were normal after half hour. Resting/icing legs.

MedDRA releases: 2024-11 · check-in free text available
2022-07-27
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-09-16
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-09
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-11-28
Survey response — day 14, dose 4
MedDRA: Headache, Musculoskeletal stiffness — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Very heavy headaches and stiff neck

MedDRA releases: 2024-11 · check-in free text available
2022-12-02
Survey response — day 21, dose 4
MedDRA: Abdominal pain upper — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stomach pain

MedDRA releases: 2024-11 · check-in free text available
2022-12-07
Survey response — day 28, dose 4
MedDRA: Fatigue, Insomnia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: fatigued with insomnia

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Janssen/Johnson & Johnson
2	2021-11-06	Pfizer-BioNTech	No
3	2022-06-15	Pfizer-BioNTech	No
4	2022-11-09	Pfizer-BioNTech	Flu

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): cold sweat

2021-03-11

Systemic reaction (other): just 2 hours in morning

Release 5 — day 7, dose 1

2021-03-12

Systemic reaction (other): might have slept in wrong position; but had right side muscle stiffness in neck ; better after applying muscle cream

Release 6 — day 28, single dose

2021-04-02

Symptoms: 2 days headache, tylenol not helping, today gone

Release 7 — day 42, single dose

2021-04-16

Symptoms: 3 days of severe headaches (no migraine) , feels like crane is too small

Release 8 — 3 months, dose 1

2021-06-04

Symptoms: Mild headachesPain in left leg , poor blood circulation in upper thighLasted approximately 1,5 week and now 1 week full clear again

Release 9 — 6 months, dose 1

2021-09-03

Symptoms: Jaw joint stressed

Release 10 — days 1–6 daily, dose 2

2021-11-07

Systemic reaction (other): The muscle and joint pain goes from top of schoulder downwards to elbow and moving more downwards and intenser on Sunday

2021-11-10

Systemic reaction (other): sore injection site

Release 10 — day 21, dose 2

2021-11-28

Symptoms: 2-3 days this week of a stiff painful neck and feeling ill and intestinal issues, no fever though.

Release 10 — day 35, dose 2

2021-12-16

Symptoms: Since return from Belize flight on 12/15 Headache, neck pain, chirping in ear, dizziness and nausea on head-movement

Release 12 — day 28, dose 3

2022-07-13

Symptoms: Severe headaches started again last Friday and ongoing

Release 12 — day 35, dose 3

2022-07-20

Symptoms: Busted knee and twisted ankle after a fall on the concrete backyard as unbalanced. Had medical shock as well and vitals only were normal after half hour. Resting/icing legs.

Release 12 — day 14, dose 4

2022-11-28

Symptoms: Very heavy headaches and stiff neck

Release 12 — day 21, dose 4

2022-12-02

Symptoms: Stomach pain

Release 12 — day 28, dose 4

2022-12-07

Symptoms: fatigued with insomnia

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	Abdominal pain upper	·	·	✓
SD	Cardiovascular insufficiency	○	✓	○
SD	Dizziness postural	·	·	✓
SD	Fall	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Ligament sprain	·	·	✓
SD	Lower limb fracture	·	·	✓
SD	Malaise	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Nausea	·	·	✓
SD	Neck pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Poor peripheral circulation	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Shock	·	·	✓
SD	Temporomandibular joint syndrome	✓	·	✓
SD	Thinking abnormal	○	✓	○
SD	Tinnitus	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Cold sweat	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Myalgia	·	·	✓

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