5JC-20406-40845

4 vaccinations 27 coded responses 55 check-ins 21 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 945 / CA
Registered: 2021-03-24

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

Registered dependents

A6L-81237-43452 Child or adolescent in my care · Male · 2021-09-09

Timeline

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

2021-03-23
Dose 1 — Janssen/Johnson & Johnson
2021-03-24
Registered in v-safe
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Hypoacusis, Tinnitus — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right ear pain, tinnitus, muffled hearing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoacusis, Tinnitus — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Right ear muffled hearing and tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Hypoacusis, Lymphadenopathy, Tinnitus — Feeling: Good · Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Lymphadenopathy right axilla , right ear muffled hearing/pre and post auricular pain, tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Headache, Hypoacusis, Lymphadenopathy, Pre-existing disease, Tinnitus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Right axilla lymphadenopathy, right ear muffled hearing and tinnitus, right ear pre and post auricular pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 7, dose 1
MedDRA: Hypoacusis, Lymphadenopathy, Pain, Tinnitus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right ear muffled hearing, tinnitus and right ear pre/post auricular pain right axilla lymphadenopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 21, single dose
MedDRA: New daily persistent headache — Feeling: Fair

Free text: Daily Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 28, single dose
MedDRA: Dizziness, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lightheaded dizziness fatigue headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-04
Survey response — day 42, single dose
MedDRA: Headache — Feeling: Fair

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-12-08
Dose 2 — Pfizer-BioNTech
2021-12-08
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache

Free text: Dizziness/lightheaded

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-12-10
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lymphadenopathy right armpit

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Clavicle and armpit lymphadenopathy

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right arm pit lymphadenopathy

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right armpit lymphadenopathy - pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right armpit lymphadenopathy and pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right armpit lymphadenopathy and pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Survey response — day 14, dose 2
MedDRA: Chest pain — Feeling: Good

Free text: Intermittent Chest pain/soreness.

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2022-01-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-01-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-03-09
Survey response — 3 months, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chronic GI upset

MedDRA releases: 2024-11 · check-in free text available
2022-06-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-08-12
Dose 3 — Pfizer-BioNTech
2022-08-12
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Itching · Chills

Adult check-in
2022-08-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-08-14
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-08-15
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, 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
2022-08-16
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Feeling lightheaded

MedDRA releases: 2024-11 · check-in free text available
2022-08-17
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Lymphadenopathy under right armpit (arm had injection)

MedDRA releases: 2024-11 · check-in free text available
2022-08-18
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Right armpit lymphadenopathy and tenderness

MedDRA releases: 2024-11 · check-in free text available
2022-08-19
Survey response — day 7, dose 3
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Right armpit lymphadenopathy and pain

MedDRA releases: 2024-11 · check-in free text available
2022-08-26
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-09-02
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-09-09
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-09-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-09-23
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-11-11
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2023-02-10
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-02-24
Dose 4 — Pfizer-BioNTech
2023-02-24
Health check-in — day 0, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2023-02-27
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11
2023-02-28
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-01
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-02
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-03
Survey response — day 7, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-11
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2023-03-17
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-03-24
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-03-31
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-04-07
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-05-26
Survey response — 3 months, dose 4
MedDRA: COVID-19, Cough, Fatigue, Insomnia, Wheezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-26
Call case (no matching report) — Unsuccessful
2023-05-30
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Janssen/Johnson & Johnson
2	2021-12-08	Pfizer-BioNTech	No
3	2022-08-12	Pfizer-BioNTech	No
4	2023-02-24	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-26

Systemic reaction (other): Right ear pain, tinnitus, muffled hearing

2021-03-27

Systemic reaction (other): Right ear muffled hearing and tinnitus

2021-03-28

Systemic reaction (other): Lymphadenopathy right axilla , right ear muffled hearing/pre and post auricular pain, tinnitus

2021-03-29

Systemic reaction (other): Right axilla lymphadenopathy, right ear muffled hearing and tinnitus, right ear pre and post auricular pain

Release 6 — day 7, dose 1

2021-03-30

Systemic reaction (other): Right ear muffled hearing, tinnitus and right ear pre/post auricular pain right axilla lymphadenopathy

Release 7 — day 21, single dose

2021-04-13

Symptoms: Daily Headaches

Release 7 — day 28, single dose

2021-04-20

Symptoms: Lightheaded dizziness fatigue headache

Release 8 — day 42, single dose

2021-05-04

Symptoms: Headache

Release 10 — day 0, dose 2

2021-12-08

Systemic reaction (other): Dizziness/lightheaded

Release 10 — days 1–6 daily, dose 2

2021-12-10

Systemic reaction (other): Lymphadenopathy right armpit

2021-12-11

Systemic reaction (other): Clavicle and armpit lymphadenopathy

2021-12-12

Systemic reaction (other): Right arm pit lymphadenopathy

2021-12-13

Systemic reaction (other): Right armpit lymphadenopathy - pain

2021-12-14

Systemic reaction (other): Right armpit lymphadenopathy and pain

Release 10 — day 7, dose 2

2021-12-15

Systemic reaction (other): Right armpit lymphadenopathy and pain

Release 10 — day 14, dose 2

2021-12-22

Symptoms: Intermittent Chest pain/soreness.

Release 11 — 3 months, dose 2

2022-03-09

Symptoms: Chronic GI upset

Release 12 — days 1–6 daily, dose 3

2022-08-16

Systemic reaction (other): Feeling lightheaded

2022-08-17

Systemic reaction (other): Lymphadenopathy under right armpit (arm had injection)

2022-08-18

Systemic reaction (other): Right armpit lymphadenopathy and tenderness

Release 12 — day 7, dose 3

2022-08-19

Systemic reaction (other): Right armpit lymphadenopathy and 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
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Insomnia	·	·	✓
SD	New daily persistent headache	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Wheezing	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Condition aggravated	✓	·	✓
SRO	Dizziness	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Headache	○	✓	○
SRO	Hypoacusis	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Tinnitus	✓	✓	✓

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