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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

  1. 2021-03-05
    Registered in v-safe
  2. 2021-03-05
    Dose 1 — Janssen/Johnson & Johnson
  3. 2021-03-05
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-03-06
    Survey response — days 1–6 daily, dose 1
    MedDRA: Hypoaesthesia, Immediate post-injection reaction, Injection site hypoaesthesia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches
    Free text: While nurse was giving me my vaccine the left side of my face felt sort of numb an shoulder leftShot in left arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Eye pain — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities
    Free text: My eyes hurt
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Diarrhea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  7. 2021-03-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Muscle or body aches
    Adult check-in
  8. 2021-03-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  9. 2021-03-12
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-19
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-26
    Health check-in — day 21, single dose
    Feeling: Good
    Adult check-in
  12. 2021-04-02
    Health check-in — day 28, single dose
    Feeling: Good
    Adult check-in
  13. 2021-04-09
    Survey response — day 35, single dose
    MedDRA: Headache — Feeling: Fair
    Free text: On an off head ache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-16
    Survey response — day 42, single dose
    MedDRA: Muscle spasms — Feeling: Fair
    Free 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 bed
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-06-04
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  16. 2021-09-03
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  17. 2021-10-29
    Dose 2 — Pfizer-BioNTech
    Co-administered: Flu
  18. 2021-10-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fever · Chills, Headache
    Adult check-in
  19. 2021-11-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 visit
    Free 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
  20. 2021-11-02
    Report sent to call center — days 1–6 daily, 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
    Emergency room or emergency department visit · 1 call case(s)
  21. 2021-11-03
  22. 2021-11-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Nausea · Be unable to work or attend school
    Adult check-in
  23. 2021-11-12
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-05Janssen/Johnson & Johnson
22021-10-29Pfizer-BioNTech Flu

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-06

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

2021-03-07

Systemic reaction (other): My eyes hurt

Release 7 — day 35, single dose

2021-04-09

Symptoms: On an off head ache

Release 7 — day 42, single dose

2021-04-16

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

2021-11-02

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

FieldPreferred term2021-092023-042024-11
HCVOHospitalisation · · ✓
SDHeadache ✓ ✓ ✓
SDMuscle spasms ✓ ✓ ✓
SROEmergency care · · ✓
SROEye pain ✓ ✓ ✓
SROHypoaesthesia ✓ ✓ ✓
SROImmediate post-injection reaction ✓ ✓ ✓
SROInjection site hypoaesthesia ✓ ✓ ✓

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