5UZ-18569-57521
2 vaccinations
5 coded responses
18 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 560 / MN
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Registered in v-safe
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2021-03-05
Dose 1 — Janssen/Johnson & Johnson
- 2021-03-05
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2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Hypoaesthesia, Immediate post-injection reaction, Injection site hypoaesthesia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body achesFree text: While nurse was giving me my vaccine the left side of my face felt sort of numb an shoulder leftShot in left armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Eye pain — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: My eyes hurtMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-03-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
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2021-03-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
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2021-04-09
Survey response — day 35, single doseMedDRA: Headache — Feeling: FairFree text: On an off head acheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — day 42, single doseMedDRA: Muscle spasms — Feeling: FairFree text: During the night while sleeping I was awakenWith terrible leg cramps inside my left leg like bad Charlie horses. It went from my toes all the way up my inner leg top to bottom.. went on for a good half hour.. then I had to try to get back in bedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-04
- 2021-09-03
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2021-10-29
Dose 2 — Pfizer-BioNTechCo-administered: Flu
- 2021-10-31
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2021-11-02
Survey response — days 1–6 daily, dose 2MedDRA: Emergency care, Hospitalisation — Feeling: Poor · Chills, Headache, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Systemic reaction (other): Being transferred to (b)(6) With possible GI Bleed · Healthcare visit (other): Being admitted to (b)(6)MedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Report sent to call center — days 1–6 daily, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2021-11-03
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2021-11-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Nausea · Be unable to work or attend schoolAdult check-in
- 2021-11-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-29 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): While nurse was giving me my vaccine the left side of my face felt sort of numb an shoulder leftShot in left arm
Systemic reaction (other): My eyes hurt
Release 7 — day 35, single dose
Symptoms: On an off head ache
Release 7 — day 42, single dose
Symptoms: During the night while sleeping I was awakenWith terrible leg cramps inside my left leg like bad Charlie horses. It went from my toes all the way up my inner leg top to bottom.. went on for a good half hour.. then I had to try to get back in bed
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Being transferred to (b)(6) With possible GI Bleed
Healthcare visit (other): Being admitted to (b)(6)
redacted (b)(6)
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 |
|---|---|---|---|---|
| HCVO | Hospitalisation | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Emergency care | · | · | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Injection site hypoaesthesia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release