6UB-19775-72554

3 vaccinations 8 coded responses 25 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 986 / WA
Registered: 2021-03-31

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-30
Dose 1 — Janssen/Johnson & Johnson
2021-03-31
Registered in v-safe
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Pain in jaw — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: A really bad headache that moved down my head and settled in my upper jaw.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Headache — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Severe headache and extreme weakness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Severe headache again today, will not go away. I have been in bed for 3 days now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work

Free text: I discovered a rash on both of my elbows last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-20
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 28, single dose
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Probable stress induced diverticulitis flare. Probably nothing to do with the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-29
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-28
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-26
Dose 2 — Pfizer-BioNTech
2021-10-28
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: I had a headache on the day following the booster

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Site: Redness · Fatigue or tiredness

Free text: Some tiredness yesterday too

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-03-30
Dose 3 — Pfizer-BioNTech
2022-04-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-06-29
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-09-30
Survey response — 6 months, dose 3
MedDRA: Benign tumour excision, Tongue neoplasm benign — Feeling: Fair · Be unable to do your normal daily activities

Free text: I had a surgery to remove a granular cell tumor on my tongue. It was benign. But the surgery and recovery were difficult.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-30	Janssen/Johnson & Johnson
2	2021-10-26	Pfizer-BioNTech	No
3	2022-03-30	Pfizer-BioNTech	No

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-01

Systemic reaction (other): A really bad headache that moved down my head and settled in my upper jaw.

2021-04-02

Systemic reaction (other): Severe headache and extreme weakness.

2021-04-03

Systemic reaction (other): Severe headache again today, will not go away. I have been in bed for 3 days now.

2021-04-04

Systemic reaction (other): I discovered a rash on both of my elbows last night

Release 8 — day 28, single dose

2021-04-29

Symptoms: Probable stress induced diverticulitis flare. Probably nothing to do with the vaccine.

Release 10 — days 1–6 daily, dose 2

2021-10-28

Systemic reaction (other): I had a headache on the day following the booster

2021-10-30

Systemic reaction (other): Some tiredness yesterday too

Release 12 — 6 months, dose 3

2022-09-30

Symptoms: I had a surgery to remove a granular cell tumor on my tongue. It was benign. But the surgery and recovery were difficult.

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	Benign tumour excision	·	·	✓
SD	Tongue neoplasm benign	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Rash	✓	✓	✓

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