65R-15644-32221
3 vaccinations
6 coded responses
29 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 125 / NY
- Registered
- 2021-04-02
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- N/A
Timeline
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2021-04-02
Registered in v-safe
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2021-04-02
Dose 1 — Janssen/Johnson & Johnson
- 2021-04-02
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2021-04-03
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Fatigue — Feeling: Good · Site: Pain, SwellingFree text: lightheadedness and slight fatigue as a resultMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Migraine, Pre-existing disease, Self-medication — Feeling: Good · Site: Pain, Redness · Headache · Be unable to do your normal daily activitiesFree text: Headache was a migraine (which I'm prone to having) and only got better after taking TylenolMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-07
Survey response — days 1–6 daily, dose 1MedDRA: Blister, Rash — Feeling: Good · Headache, Rash, not including the immediate area around the injection siteFree text: Rash includes blisters and small bumps on hands that Ive been having but of which had mostly disappeared until new ones this morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-08
- 2021-04-11
- 2021-04-16
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2021-04-23
Survey response — day 21, single doseMedDRA: Pre-existing disease, Rash — Feeling: GoodFree text: Rash on hands and arms (which I had before the vaccine)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-02
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2021-05-08
Survey response — day 35, single doseMedDRA: Burning sensation, Pruritus, Specialist consultation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: General burning and itchiness, which Ive been suffering from for a few weeks now, possibly an allergic reaction to something · Healthcare visit (other): Regular dermatologist appointmentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-08
Report sent to call center — day 35, single doseGet care from a doctor or other healthcare professional1 call case(s)
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2021-05-16
Survey response — day 42, single doseMedDRA: Migraine, Skin burning sensation — Feeling: Good · Be unable to do your normal daily activitiesFree text: Burning sensation of skin (might be related to rash and possible allergic reaction I've had), migraines (may be related to reduction is dosage of medication)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-30
Call successfulDoes not wish to fill out VAERS report
- 2021-07-04
- 2021-10-03
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2021-11-10
Dose 2 — Moderna
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2021-11-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Abdominal painAdult check-in
- 2021-11-14
- 2021-11-15
- 2021-11-17
- 2021-11-24
- 2021-12-03
- 2021-12-08
- 2021-12-15
- 2021-12-22
- 2022-02-09
- 2022-05-14
-
2022-09-23
Dose 3 — ModernaCo-administered: Flu
- 2022-10-14
- 2022-10-21
- 2022-10-30
- 2022-11-06
- 2022-12-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-10 | Moderna | No |
| 3 | 2022-09-23 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): lightheadedness and slight fatigue as a result
Systemic reaction (other): Headache was a migraine (which I'm prone to having) and only got better after taking Tylenol
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Rash includes blisters and small bumps on hands that Ive been having but of which had mostly disappeared until new ones this morning
Release 7 — day 21, single dose
Symptoms: Rash on hands and arms (which I had before the vaccine)
Release 8 — day 35, single dose
Symptoms: General burning and itchiness, which Ive been suffering from for a few weeks now, possibly an allergic reaction to something
Healthcare visit (other): Regular dermatologist appointment
Release 8 — day 42, single dose
Symptoms: Burning sensation of skin (might be related to rash and possible allergic reaction I've had), migraines (may be related to reduction is dosage of medication)
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 | Specialist consultation | ✓ | ✓ | ✓ |
| SD | Burning sensation | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ○ |
| SD | Skin burning sensation | ✓ | ✓ | ✓ |
| SRO | Blister | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Migraine | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release