68J-26704-00397
4 vaccinations
8 coded responses
42 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 554 / MN
- Registered
- 2021-03-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-15
Registered in v-safe
-
2021-03-15
Dose 1 — Janssen/Johnson & Johnson
-
2021-03-15
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort — Feeling: Fair · Muscle or body achesFree text: Heavy feeling in chest...could be spring allergies.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-14
- 2021-04-19
- 2021-04-26
- 2021-06-14
-
2021-09-15
Survey response — 6 months, dose 1MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Rash nearby belly buttonMedDRA releases: 2024-11 · check-in free text available
-
2021-09-15
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-10-25
Dose 2 — Pfizer-BioNTechCo-administered: Flu
- 2021-10-31
-
2021-11-01
Survey response — day 7, dose 2MedDRA: Chills, Fatigue, Injection site pain, Myalgia — Feeling: GoodFree text: I had muscle pain, arm pain at injection, fatigue and chills on 10/27 and 10/28. I am fine now.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
-
2021-12-06
Survey response — day 42, dose 2MedDRA: Hypersensitivity — 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 · Outpatient clinic or urgent care clinic visitFree text: Allergic reaction to Shingles VaccineMedDRA releases: 2024-11 · check-in free text available
-
2021-12-06
Report sent to call center — day 42, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-12-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-24
-
2022-04-08
Dose 3 — Pfizer-BioNTech
-
2022-04-11
Survey response — days 1–6 daily, dose 3MedDRA: Feeling cold, Headache — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to work or attend schoolFree text: Yesterday I experienced intense head ache from back of mouth up to ear and intense cold feeling (like a headache you get after eating something cold). Today my mouth feels like I just ate something cold. The feeling has been there all day.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-12
Survey response — days 1–6 daily, dose 3MedDRA: Ageusia, Nasopharyngitis, Oral mucosal eruption, Pharyngeal enanthema, Tongue eruption — Feeling: GoodFree text: Still Ave cold tongue and throat and spots in my mouth where I can't tasteMedDRA releases: 2024-11 · check-in free text available
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2022-04-13
Survey response — days 1–6 daily, dose 3MedDRA: Oral disorder, Taste disorder — Feeling: Fair · Nausea, Abdominal painFree text: Taste and mouth are not notmalMedDRA releases: 2024-11 · check-in free text available
- 2022-04-14
- 2022-04-15
- 2022-04-24
- 2022-05-01
- 2022-05-08
- 2022-05-13
-
2022-05-20
Survey response — day 42, dose 3MedDRA: Scleroderma — Feeling: GoodFree text: Sclerosis-skinMedDRA releases: 2024-11 · check-in free text available
- 2022-07-08
-
2022-09-27
Dose 4 — Pfizer-BioNTech
-
2022-10-06
Health check-in — day 7, dose 4Feeling: Good · Site: Pain · None · Be unable to work or attend schoolAdult check-in
- 2022-10-11
- 2022-10-18
- 2022-10-25
- 2022-11-03
- 2022-11-08
- 2022-12-27
- 2023-03-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-25 | Pfizer-BioNTech | Flu |
| 3 | 2022-04-08 | Pfizer-BioNTech | No |
| 4 | 2022-09-27 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Heavy feeling in chest...could be spring allergies.
Release 9 — 6 months, dose 1
Symptoms: Rash nearby belly button
Release 10 — day 7, dose 2
Systemic reaction (other): I had muscle pain, arm pain at injection, fatigue and chills on 10/27 and 10/28. I am fine now.
Release 10 — day 42, dose 2
Symptoms: Allergic reaction to Shingles Vaccine
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): Yesterday I experienced intense head ache from back of mouth up to ear and intense cold feeling (like a headache you get after eating something cold). Today my mouth feels like I just ate something cold. The feeling has been there all day.
Systemic reaction (other): Still Ave cold tongue and throat and spots in my mouth where I can't taste
Systemic reaction (other): Taste and mouth are not notmal
Release 11 — day 42, dose 3
Symptoms: Sclerosis-skin
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 | Hypersensitivity | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Scleroderma | · | · | ✓ |
| SRO | Ageusia | · | · | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Feeling cold | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Nasopharyngitis | · | · | ✓ |
| SRO | Oral disorder | · | · | ✓ |
| SRO | Oral mucosal eruption | · | · | ✓ |
| SRO | Pharyngeal enanthema | · | · | ✓ |
| SRO | Taste disorder | · | · | ✓ |
| SRO | Tongue eruption | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release