53D-12304-58976

3 vaccinations 16 coded responses 33 check-ins 14 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 920 / CA
Registered: 2021-03-13

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

Timeline

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

2021-03-12
Dose 1 — Janssen/Johnson & Johnson
2021-03-13
Registered in v-safe
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness, Abdominal pain

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Abdominal pain

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site discolouration — Feeling: Good · Site: Pain · Fever

Free text: There is a white circle around the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 21, single dose
MedDRA: Paranasal sinus discomfort, Seasonal allergy — Feeling: Fair

Free text: Sinus pressure, most likely from pollen allergies. I get this fairly often

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 28, single dose
MedDRA: Injection site scab, Pain in extremity — Feeling: Good

Free text: My arm s still sore and there is a small scab at the injection site that continues to return

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — day 42, single dose
MedDRA: Chest discomfort — Feeling: Good

Free text: I feel feverish sometimes and another weird feeling in my head and chest I cant really describe. Maybe like pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — 3 months, dose 1
MedDRA: Abdominal pain upper, Pain in extremity, Tenderness — Feeling: Good

Free text: Regular stomach painMy arm is still sore to the touch, but not badly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-11-01
Dose 2 — Moderna
2021-11-01
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Neck pain — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Shoulder and neck pain from yesterday is slowly getting better

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-11-07
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good · Fever · Chills, Headache, Muscle or body aches

Free text: Stiff neck and shoulders

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Survey response — day 7, dose 2
MedDRA: Arthralgia, Back pain, Neck pain — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My shoulders and neck and back are sore

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — day 14, dose 2
MedDRA: Arthralgia, Back pain, Dizziness, Headache, Neck pain — 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 · Telehealth, virtual health, or email health consultation

Free text: My neck and upper back and shoulders are very sore and have been since a few days after the booster. I get a daily headache, sometimes dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Report sent to call center — day 14, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-16
Call successful
Participant prefers to complete VAERS report online
2021-11-22
Survey response — day 21, dose 2
MedDRA: Arthralgia, Back pain, Neck pain, Oropharyngeal pain, Pyrexia, Throat tightness — 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 · Telehealth, virtual health, or email health consultation

Free text: Very sore neck, shoulders and back Sometimes feverish Strange tight and sore feeling in my throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Report sent to call center — day 21, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-23
Call successful
Other
2021-11-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-08
Survey response — day 35, dose 2
MedDRA: Arthralgia, Back pain — Feeling: Fair · 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: Back and shoulder pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-09
Call 2 — Left Voicemail
2021-12-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-02-01
Survey response — 3 months, dose 2
MedDRA: Malaise — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I didn't feel well at all

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Dose 3 — Pfizer-BioNTech
2022-11-01
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-11-01
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-11-08
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-11-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-11-22
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-11-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2023-01-17
Survey response — 3 months, dose 3
MedDRA: Adverse drug reaction — 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

MedDRA releases: 2024-11
2023-01-17
Report sent to call center — 3 months, dose 3
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)
2023-01-18
Call 1 — Left Voicemail
2023-01-18
Call 1 — Left Voicemail
2023-04-18
Survey response — 6 months, dose 3
MedDRA: Gastric ulcer — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Janssen/Johnson & Johnson
2	2021-11-01	Moderna	No
3	2022-10-18	Pfizer-BioNTech	No

Call center

4 call center cases

2 successful · 2 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): None

2021-03-14

Systemic reaction (other): None

2021-03-16

Systemic reaction (other): There is a white circle around the injection site

Release 6 — day 21, single dose

2021-04-02

Symptoms: Sinus pressure, most likely from pollen allergies. I get this fairly often

Release 7 — day 28, single dose

2021-04-09

Symptoms: My arm s still sore and there is a small scab at the injection site that continues to return

Release 7 — day 42, single dose

2021-04-23

Symptoms: I feel feverish sometimes and another weird feeling in my head and chest I cant really describe. Maybe like pressure

Release 9 — 3 months, dose 1

2021-06-11

Symptoms: Regular stomach painMy arm is still sore to the touch, but not badly

Release 10 — days 1–6 daily, dose 2

2021-11-04

Systemic reaction (other): Shoulder and neck pain from yesterday is slowly getting better

2021-11-07

Systemic reaction (other): Stiff neck and shoulders

Release 10 — day 7, dose 2

2021-11-08

Systemic reaction (other): My shoulders and neck and back are sore

Release 10 — day 14, dose 2

2021-11-15

Symptoms: My neck and upper back and shoulders are very sore and have been since a few days after the booster. I get a daily headache, sometimes dizzy

Release 10 — day 21, dose 2

2021-11-22

Symptoms: Very sore neck, shoulders and back Sometimes feverish Strange tight and sore feeling in my throat

Release 10 — day 35, dose 2

2021-12-08

Symptoms: Back and shoulder pain

Release 11 — 3 months, dose 2

2022-02-01

Symptoms: I didn't feel well at all

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	Adverse drug reaction	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Gastric ulcer	·	·	✓
SD	Headache	·	·	✓
SD	Injection site scab	✓	✓	✓
SD	Malaise	·	·	✓
SD	Neck pain	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Seasonal allergy	✓	✓	✓
SD	Tenderness	·	·	✓
SD	Throat tightness	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Back pain	·	·	✓
SRO	Injection site discolouration	✓	✓	✓
SRO	Musculoskeletal stiffness	·	·	✓
SRO	Neck pain	·	·	✓
SRO	No adverse event	✓	✓	✓

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