9KP-21509-47242

1 vaccination 7 coded responses 9 check-ins 7 free-text entries 6 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 521 / IA
Registered: 2021-03-18

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

2021-03-17
Dose 1 — Janssen/Johnson & Johnson
2021-03-18
Registered in v-safe
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Heart rate increased — 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: dizziness, elevated heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Survey response — day 14, dose 1
MedDRA: Abortion spontaneous — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Miscarriage

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Call 1 — Left Voicemail
2021-04-14
Survey response — day 28, single dose
MedDRA: Anxiety, Neuropathy peripheral — Feeling: Poor · 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: Neuropathy, anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 28, single dose
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — day 35, single dose
MedDRA: Paraesthesia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Tingling pins and needles in hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 35, single dose
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Health check-in — day 42, single dose
Feeling: Poor

Adult check-in
2021-04-30
Call 1 — Left Voicemail
2021-06-16
Survey response — 3 months, dose 1
MedDRA: Dizziness, Dyspnoea, Heart rate increased, Hypertension, Neuralgia, Palpitations — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: High heart rate and blood pressure, lightheaded, palpitations, SOB, nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Report sent to call center — 3 months, dose 1
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Call 2 — Left Voicemail
2021-09-19
Survey response — 6 months, dose 1
MedDRA: Bradycardia, Neuropathy peripheral, Paraesthesia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Pins Needles neuropathy , bradycardia

MedDRA releases: 2024-11 · check-in free text available
2021-09-19
Report sent to call center — 6 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-20
Call 1 — Left Voicemail
2022-03-17
Survey response — 12 months, dose 1
MedDRA: Amnesia, Ascites, Bradycardia, Depression, Dizziness, Fatigue, Headache, Hypotension, Insomnia, Menstruation irregular, Palpitations, Paraesthesia, Pleural effusion, Tachycardia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Memory loss, tachycardia, bradycardia, headaches, pleural effusion, ascites, low blood pressure, lightheaded, palpitations, insomnia, depression, parasthesia, pins and needles, extreme fatigue, irregular menstural cycle

MedDRA releases: 2024-11 · check-in free text available
2022-03-17
Report sent to call center — 12 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-03-18
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Janssen/Johnson & Johnson

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Unsuccessful
2021-04-14	Unsuccessful
2021-04-22	Unsuccessful
2021-06-16	Unsuccessful
2021-09-19	Unsuccessful
2022-03-17	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): dizziness, elevated heart rate

Release 6 — day 14, dose 1

2021-04-01

Symptoms: Miscarriage

Release 7 — day 28, single dose

2021-04-14

Symptoms: Neuropathy, anxiety

Release 7 — day 35, single dose

2021-04-22

Symptoms: Tingling pins and needles in hands

Release 9 — 3 months, dose 1

2021-06-16

Symptoms: High heart rate and blood pressure, lightheaded, palpitations, SOB, nerve pain

Release 9 — 6 months, dose 1

2021-09-19

Symptoms: Pins Needles neuropathy , bradycardia

Release 11 — 12 months, dose 1

2022-03-17

Symptoms: Memory loss, tachycardia, bradycardia, headaches, pleural effusion, ascites, low blood pressure, lightheaded, palpitations, insomnia, depression, parasthesia, pins and needles, extreme fatigue, irregular menstural cycle

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	Amnesia	·	·	✓
SD	Anxiety	✓	✓	✓
SD	Ascites	·	·	✓
SD	Bradycardia	·	·	✓
SD	Depression	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Hypotension	·	·	✓
SD	Insomnia	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Neuropathy peripheral	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Pleural effusion	·	·	✓
SD	Tachycardia	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓

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