5TV-11644-71176

3 vaccinations 9 coded responses 28 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 020 / MA
Registered: 2021-04-13

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

Timeline

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

2021-04-11
Dose 1 — Janssen/Johnson & Johnson
2021-04-13
Registered in v-safe
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Poor peripheral circulation — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Poor circulation in toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Mild brain fog

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

Adult check-in
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Poor peripheral circulation — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Free text: Poor circulation in feet and toes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 1
MedDRA: Poor peripheral circulation — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Poor circulation in feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — day 7, dose 1
MedDRA: Peripheral coldness, Peripheral vascular disorder — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Free text: Freezing feet/ poor circulation, again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — day 14, dose 1
MedDRA: Pre-existing disease — Feeling: Good

Free text: Flare up of old soft tissue injury to finger and hand for no reason

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-09
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-16
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-23
Survey response — day 42, single dose
MedDRA: Condition aggravated, Pre-existing disease, Tremor — Feeling: Fair

Free text: Nerve injury in hand acting up considerably for no apparent reason, with noticeable pointer finger tremor which is new.

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

Adult check-in
2021-10-12
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-22
Dose 2 — Pfizer-BioNTech
Co-administered: Flu
2021-11-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 28, dose 2
MedDRA: Periorbital cellulitis — Feeling: Poor · 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

Free text: Periorbital cellulitis infection came on with no known cause

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 28, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-24
Call successful
Participant prefers to complete VAERS report online
2021-11-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-22
Survey response — 6 months, dose 2
MedDRA: Herpes zoster — Feeling: Good · 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, Outpatient clinic or urgent care clinic visit

Free text: Several shingles infections

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 6 months, 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-25
Call 1 — Left Voicemail
2022-09-25
Dose 3 — Moderna
2022-09-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-18
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2023-03-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-11	Janssen/Johnson & Johnson
2	2021-10-22	Pfizer-BioNTech	Flu
3	2022-09-25	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-13

Systemic reaction (other): Poor circulation in toes

2021-04-14

Systemic reaction (other): Mild brain fog

2021-04-16

Systemic reaction (other): Poor circulation in feet and toes

2021-04-17

Systemic reaction (other): Poor circulation in feet

Release 7 — day 7, dose 1

2021-04-18

Systemic reaction (other): Freezing feet/ poor circulation, again

Release 7 — day 14, dose 1

2021-04-25

Symptoms: Flare up of old soft tissue injury to finger and hand for no reason

Release 8 — day 42, single dose

2021-05-23

Symptoms: Nerve injury in hand acting up considerably for no apparent reason, with noticeable pointer finger tremor which is new.

Release 10 — day 28, dose 2

2021-11-19

Symptoms: Periorbital cellulitis infection came on with no known cause

Release 11 — 6 months, dose 2

2022-04-22

Symptoms: Several shingles infections

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	Condition aggravated	✓	✓	✓
SD	Herpes zoster	·	·	✓
SD	Periorbital cellulitis	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Peripheral vascular disorder	✓	✓	✓
SRO	Poor peripheral circulation	✓	✓	✓

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