554-18628-51907

3 vaccinations 7 coded responses 33 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 981 / WA
Registered: 2021-04-10

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

2021-04-10
Registered in v-safe
2021-04-10
Dose 1 — Janssen/Johnson & Johnson
2021-04-10
Survey response — day 0, dose 1
MedDRA: Chest discomfort, Dizziness, Palpitations — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Light headed, heart palpitations, minor chest tightness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Nausea

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-19
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, single dose
Feeling: Fair

Adult check-in
2021-05-08
Survey response — day 28, single dose
MedDRA: Arthritis, Headache, Pre-existing disease — Feeling: Fair

Free text: Headache, arthritis flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — day 35, single dose
Feeling: Fair

Adult check-in
2021-05-25
Survey response — day 42, single dose
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-10-23
Dose 2 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-11-13
Survey response — day 21, dose 2
MedDRA: Alopecia, Inflammation, Pruritus, Rash, Skin discomfort — Feeling: Fair

Free text: Hair loss, new alopecia spot appeared. Minor inflammation on face. New, mild rash and skin itching/discomfort.

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-11-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-12-06
Dose 3 — Moderna
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-13
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-12-22
Survey response — day 14, dose 3
MedDRA: Arthralgia, Headache — Feeling: Fair

Free text: Increased frequency of headaches and increased joint pain- but not uncommon during this season on a typical year

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-04
Survey response — day 28, dose 3
MedDRA: Alopecia, Pre-existing disease — Feeling: Good

Free text: Increased hair loss (history of alopecia triggered by immune modulating treatments)

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-06
Survey response — 6 months, dose 3
MedDRA: Alopecia — Feeling: Good

Free text: Hair loss

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Janssen/Johnson & Johnson
2	2021-10-23	Moderna	No
3	2021-12-06	Moderna	No

Free text

Release 7 — day 0, dose 1

2021-04-10

Systemic reaction (other): Light headed, heart palpitations, minor chest tightness

Release 8 — day 28, single dose

2021-05-08

Symptoms: Headache, arthritis flare

Release 8 — day 42, single dose

2021-05-25

Symptoms: Fatigue

Release 10 — day 21, dose 2

2021-11-13

Symptoms: Hair loss, new alopecia spot appeared. Minor inflammation on face. New, mild rash and skin itching/discomfort.

Release 10 — day 14, dose 3

2021-12-22

Symptoms: Increased frequency of headaches and increased joint pain- but not uncommon during this season on a typical year

Release 10 — day 28, dose 3

2022-01-04

Symptoms: Increased hair loss (history of alopecia triggered by immune modulating treatments)

Release 11 — 6 months, dose 3

2022-06-06

Symptoms: Hair loss

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	Alopecia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Arthritis	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Inflammation	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Rash	·	·	✓
SD	Skin discomfort	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Palpitations	✓	✓	✓

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