6VQ-64053-12332

2 vaccinations 17 coded responses 28 check-ins 17 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 980 / WA
Registered: 2021-03-20

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

Timeline

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Survey response — day 0, dose 1
MedDRA: Anaphylactic reaction, Hospitalisation — Feeling: Fair · Fever · 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: Anaphylaxis, requiring parental Rx and observation stay in ED

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — day 0, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Emergency care — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Recurrence of the signs/symptoms that resulted in my ED stay on the day of vaccination. Have just begin tapering course of prednisolone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Now on day 2 of tapering course of prednisolone; other symptoms are improving

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Cardiovascular disorder — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Continued CV signs/symptoms despite being on prednisolone taper. Began propranolol tonight.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Hypertension, Tachycardia — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hypertensive/tachycardic episodes have stopped since starting propranolol yesterday evening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Hypertension, Tachycardia — Feeling: Fair · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Reoccurrence of hypertension/tachycardia. Propranolol no longer PRN. New tapering course of steroids begun with higher dose. Daily famotidine begun.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Survey response — day 7, dose 1
MedDRA: Cardiovascular disorder, Emergency care — Feeling: Fair · Chills, Fatigue or tiredness · 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): Continued cardiovascular issues while on prednisolone, propranolol and famotidine. · Healthcare visit (other): ED visit yesterday evening, after yesterday's survey completed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-03
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-05-27
Dose 2 — Janssen/Johnson & Johnson
2021-05-28
Survey response — days 1–6 daily, dose 2
MedDRA: Thirst, Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Intense thirst, despite not eating salty foods. Drank > 64 oz H2O. Temp is temporal artery; normal for me is around 97.4

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — days 1–6 daily, dose 2
MedDRA: Thirst — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Reduced thirst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-31
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Mild dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness

Free text: One episode of dizziness today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-06-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-10
Survey response — day 14, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: On day 12 after vaccination, had 24 hours of a distinct and very distracting crawling sensation around the injection site. No change in activities that might explain it; no symptoms elsewhere. Gradually remitted; gone now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-24
Survey response — day 28, dose 2
MedDRA: Back pain, Injury — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sustained an injury that has resulted in ADL-limiting back pain <groan>

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-28
Call 1 — Left Voicemail
2021-07-01
Survey response — day 35, dose 2
MedDRA: Back injury, Back pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Continued problems with pain after back injury (not COVID-related)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Survey response — day 42, dose 2
MedDRA: Back injury, Back pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Back pain following back injury; unrelated to vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-09
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-25
Call 1 — Left Voicemail
2021-08-26
Survey response — 3 months, dose 2
MedDRA: Back injury, Injury — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Self-inflicted back injury, slowly getting better.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 1 — Left Voicemail
2021-11-25
Survey response — 6 months, dose 2
MedDRA: Hypoaesthesia, Limb injury, Pain in extremity, Peripheral swelling — Feeling: Good

Free text: For about the past month have had a swollen and numb right second toe which is sometimes painful. Likely due to an unnoticed injury. (...you are not asking, but I did get a COVID booster two weeks ago, another J&J)

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-05-27	Janssen/Johnson & Johnson

Call center

8 call center cases

8 unsuccessful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-20

Systemic reaction (other): Anaphylaxis, requiring parental Rx and observation stay in ED

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): Recurrence of the signs/symptoms that resulted in my ED stay on the day of vaccination. Have just begin tapering course of prednisolone.

2021-03-23

Systemic reaction (other): Now on day 2 of tapering course of prednisolone; other symptoms are improving

2021-03-24

Systemic reaction (other): Continued CV signs/symptoms despite being on prednisolone taper. Began propranolol tonight.

2021-03-25

Systemic reaction (other): Hypertensive/tachycardic episodes have stopped since starting propranolol yesterday evening.

2021-03-26

Systemic reaction (other): Reoccurrence of hypertension/tachycardia. Propranolol no longer PRN. New tapering course of steroids begun with higher dose. Daily famotidine begun.

Release 6 — day 7, dose 1

2021-03-27

Systemic reaction (other): Continued cardiovascular issues while on prednisolone, propranolol and famotidine.

Healthcare visit (other): ED visit yesterday evening, after yesterday's survey completed

Release 8 — days 1–6 daily, dose 2

2021-05-28

Systemic reaction (other): Intense thirst, despite not eating salty foods. Drank > 64 oz H2O. Temp is temporal artery; normal for me is around 97.4

2021-05-29

Systemic reaction (other): Reduced thirst

2021-05-31

Systemic reaction (other): Mild dizziness

2021-06-01

Systemic reaction (other): One episode of dizziness today

Release 9 — day 14, dose 2

2021-06-10

Symptoms: On day 12 after vaccination, had 24 hours of a distinct and very distracting crawling sensation around the injection site. No change in activities that might explain it; no symptoms elsewhere. Gradually remitted; gone now.

Release 9 — day 28, dose 2

2021-06-24

Symptoms: Sustained an injury that has resulted in ADL-limiting back pain <groan>

Release 9 — day 35, dose 2

2021-07-01

Symptoms: Continued problems with pain after back injury (not COVID-related)

Release 9 — day 42, dose 2

2021-07-09

Symptoms: Back pain following back injury; unrelated to vaccination.

Release 9 — 3 months, dose 2

2021-08-26

Symptoms: Self-inflicted back injury, slowly getting better.

Release 10 — 6 months, dose 2

2021-11-25

Symptoms: For about the past month have had a swollen and numb right second toe which is sometimes painful. Likely due to an unnoticed injury. (...you are not asking, but I did get a COVID booster two weeks ago, another J&J)

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	Emergency care	✓	✓	✓
SD	Back injury	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Injury	✓	✓	✓
SD	Limb injury	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Anaphylactic reaction	✓	✓	✓
SRO	Cardiovascular disorder	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Tachycardia	✓	✓	✓
SRO	Thirst	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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