5XF-22136-32152
1 vaccination
1 coded response
14 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 970 / OR
- Registered
- 2021-05-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-15
Dose 1 — Janssen/Johnson & Johnson
-
2021-05-16
Registered in v-safe
-
2021-05-16
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Joint pains, DiarrheaAdult check-in
- 2021-05-18
- 2021-05-19
-
2021-05-20
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Diarrhea, Abdominal painAdult check-in
- 2021-05-21
- 2021-05-22
- 2021-05-29
- 2021-06-07
- 2021-06-12
- 2021-06-19
- 2021-06-26
- 2021-08-14
-
2022-05-15
Survey response — 12 months, dose 1MedDRA: Abortion spontaneous, COVID-19 — Feeling: Fair · 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 visitFree text: Pregnancy Pregnancy loss CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-05-15
Report sent to call center — 12 months, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-16
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-15 | Janssen/Johnson & Johnson |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-15 | Successful 2022-05-16 |
Not applicable - Accidental Reporting |
Free text
Release 11 — 12 months, dose 1
Symptoms: Pregnancy Pregnancy loss Covid
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 | Abortion spontaneous | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release