5MP-19050-89003

4 vaccinations 17 coded responses 31 check-ins 17 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 487 / MI
Registered: 2021-03-31

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

2021-03-31
Registered in v-safe
2021-03-31
Dose 1 — Janssen/Johnson & Johnson
2021-03-31
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Chills

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Ocular discomfort, Sensitive skin — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Sensitive skin and eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Itching · Abdominal pain

Free text: Arm is sometimes sore at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms — Feeling: Good · Muscle or body aches · Be unable to do your normal daily activities

Free text: Muscle spasms in back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-04-07
Survey response — day 7, dose 1
MedDRA: Adverse reaction — Feeling: Good

Free text: This is the first day I feel whole since getting the vaccination

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

Adult check-in
2021-04-21
Survey response — day 21, single dose
MedDRA: Arthralgia, Ear pain, Lymphadenopathy, Sleep disorder, Toothache — Feeling: Good

Free text: Swollen lymph gland under my right ear with stabbing ear pain plus two back molars on left side, one upper, one lower. Ear pain woke me up at night, and lasted 2 days, off and on. Some new joint pain in left hand, one digit.

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

Free text: A never before experienced head pain. No forehead or frontal sinus pains. Throbbing internal head pain that lasted for about 3-5 minutes. In am I woke up and cleared my nose the mucus on the left side had bright red blood. Mild pain that day. The end

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

Adult check-in
2021-05-12
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-30
Survey response — 6 months, dose 1
MedDRA: Abdominal pain, Chills, Cough, Diarrhoea, Lethargy, Nausea, Pyrexia, Throat irritation — Feeling: Good · Be unable to do your normal daily activities

Free text: Coming back after road trip in June to Texas through (b)(6) Missouri staying in motels in those states, developed mild scratchy throat, cough, chills, diarrhea, nausea, mild fever, pain in abdomen, lethargy.

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Dose 2 — Pfizer-BioNTech
2022-04-02
Survey response — 12 months, dose 1
MedDRA: Arthralgia, Erythema, Joint swelling, Soft tissue inflammation — Feeling: Good

Free text: After I got my J&J shot my little finger, first joint, became red, swollen and tender. I don't know if the shot had anything to do with it, but it's never recovered, plus there were other soft tissue areas that became inflamed at the same time.

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Dose 3 — Pfizer-BioNTech
2022-10-31
Dose 4 — Moderna
2022-10-31
Survey response — day 0, dose 4
MedDRA: No adverse event — Feeling: Fair · Fatigue or tiredness

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site pain — Feeling: Good

Free text: Shot area is still a little sore.

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Survey response — day 7, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-05
Health check-in — day 35, dose 4
Feeling: Good

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

Adult check-in
2023-02-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-01
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Janssen/Johnson & Johnson
2	2021-11-12	Pfizer-BioNTech	No
3	2022-05-03	Pfizer-BioNTech	No
4	2022-10-31	Moderna	No

Free text

Release 6 — day 0, dose 1

2021-03-31

Systemic reaction (other): No

Release 6 — days 1–6 daily, dose 1

2021-04-01

Systemic reaction (other): Sensitive skin and eyes

2021-04-03

Systemic reaction (other): Arm is sometimes sore at injection site

2021-04-05

Systemic reaction (other): Muscle spasms in back

Release 7 — day 7, dose 1

2021-04-07

Systemic reaction (other): This is the first day I feel whole since getting the vaccination

Release 7 — day 21, single dose

2021-04-21

Symptoms: Swollen lymph gland under my right ear with stabbing ear pain plus two back molars on left side, one upper, one lower. Ear pain woke me up at night, and lasted 2 days, off and on. Some new joint pain in left hand, one digit.

Release 8 — day 28, single dose

2021-04-28

Symptoms: A never before experienced head pain. No forehead or frontal sinus pains. Throbbing internal head pain that lasted for about 3-5 minutes. In am I woke up and cleared my nose the mucus on the left side had bright red blood. Mild pain that day. The end cut off by CDC

Release 9 — 6 months, dose 1

2021-09-30

Symptoms: Coming back after road trip in June to Texas through (b)(6) Missouri staying in motels in those states, developed mild scratchy throat, cough, chills, diarrhea, nausea, mild fever, pain in abdomen, lethargy.

redacted (b)(6)

Release 11 — 12 months, dose 1

2022-04-02

Symptoms: After I got my J&J shot my little finger, first joint, became red, swollen and tender. I don't know if the shot had anything to do with it, but it's never recovered, plus there were other soft tissue areas that became inflamed at the same time.

Release 12 — day 0, dose 4

2022-10-31

Systemic reaction (other): No

Release 12 — days 1–6 daily, dose 4

2022-11-01

Systemic reaction (other): No

2022-11-02

Systemic reaction (other): No

2022-11-03

Systemic reaction (other): No

2022-11-04

Systemic reaction (other): Shot area is still a little sore.

2022-11-05

Systemic reaction (other): No

2022-11-06

Systemic reaction (other): No

Release 12 — day 7, dose 4

2022-11-07

Systemic reaction (other): No

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	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Ear pain	✓	✓	✓
SD	Epistaxis	✓	✓	✓
SD	Erythema	·	·	✓
SD	Headache	✓	✓	✓
SD	Joint swelling	·	·	✓
SD	Lethargy	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Soft tissue inflammation	·	·	✓
SD	Throat irritation	·	·	✓
SD	Toothache	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Sensitive skin	✓	✓	✓

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